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13-11-2024 | Original Article

Evaluation of intestinal wall closure using vessel-sealing technology versus conventional closure: an in vivo study

Authors: Toshio Shiraishi, Takashi Nonaka, Tetsuro Tominaga, Shintaro Hashimoto, Hiroshi Maruta, Keisuke Noda, Terumitsu Sawai, Keitaro Matsumoto

Published in: Surgery Today

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Abstract

Purpose

Anastomotic leakage is a major postoperative complication of colorectal surgery. LigaSure™ is used commonly for vessel-sealing, but its use for intestinal anastomosis or closure, particularly the healing process, is underreported. We conducted this study to evaluate the feasibility of using LigaSure™ for intestinal wall closure, compared with hand-sewn methods.

Methods

We performed intestinal wall closure of the cecum in rat laparotomy procedures, dividing subjects into a LigaSure™ group (LS) and a hand-sewn group (HS). We compared operation times, tissue structure changes, and pressure resistance from immediately post-operatively to postoperative day (POD) 14.

Results

No postoperative dehiscence or mortality occurred in either group. The LS group required significantly less closure time (113 s) than the HS group (321 s, p < 0.001). The adhesion rates for a midline incision were not significantly different between the groups (LS: 26.7% vs. HS: 6.7%; p = 0.142), with adhesions at the closure site seen in all subjects. The LS group had a lower burst pressure than the HS group until POD 3, with no significant differences thereafter. Structural continuity was established by POD 5 in both groups.

Conclusions

LigaSure™ provides effective intestinal wall closure with a more distinct healing process than with hand-sewn methods, suggesting the potential for staple-free anastomosis.
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Metadata
Title
Evaluation of intestinal wall closure using vessel-sealing technology versus conventional closure: an in vivo study
Authors
Toshio Shiraishi
Takashi Nonaka
Tetsuro Tominaga
Shintaro Hashimoto
Hiroshi Maruta
Keisuke Noda
Terumitsu Sawai
Keitaro Matsumoto
Publication date
13-11-2024
Publisher
Springer Nature Singapore
Published in
Surgery Today
Print ISSN: 0941-1291
Electronic ISSN: 1436-2813
DOI
https://doi.org/10.1007/s00595-024-02961-4
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