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Stapler-less burst pressure in an ex vivo human gastric tissue: a randomized controlled trial.

Authors :
Del Genio G
Gambardella C
Tolone S
Brusciano L
Parmeggiani D
Lanza Volpe M
Lucido FS
Docimo L
Source :
Updates in surgery [Updates Surg] 2021 Apr; Vol. 73 (2), pp. 679-685. Date of Electronic Publication: 2021 Jan 26.
Publication Year :
2021

Abstract

Stapler-less laparoscopic sleeve gastrectomy (LSG) is emerging as a new potential affordable cost-effective alternative procedure. However, no pre-clinical data are currently available on human tissue. We aimed to evaluate whether traditionally suturing without the use of surgical stapling may produce a comparable bursting pressure on human gastric tissue. A prospective cohort of consecutive patients undergoing LSG was divided in two groups to compare a barbed extra-mucosal running suture (stapler-less) versus a standard stapler line. A burst pressure test was applied to the gastric specimen employing high-resolution manometric catheter. Type, location and features of the leak were described. We enrolled a total of 40 obese patients, 20 patients for each group. Median burst pressures of the stapler-less group resulted statistically significant increased (p < 0.0001) than the one in standard stapler group. In all cases, leak occurred along the surgical closure site independently from the used technique (group 1 vs 2; p = N.S.), more often at the proximal stomach (p < 0.05). In human ex vivo model, traditional surgical suture (i.e. running hand-sewn) produced an effective temporary closure, with superior resistance to increasing volume and pressure. How this may impact on clinical LSG outcomes needs further evaluations and was not the object of this study.

Details

Language :
English
ISSN :
2038-3312
Volume :
73
Issue :
2
Database :
MEDLINE
Journal :
Updates in surgery
Publication Type :
Academic Journal
Accession number :
33496955
Full Text :
https://doi.org/10.1007/s13304-021-00975-y