Evaluation of bioabsorbable seamguard for staple line reinforcement in stapled rectal anastomoses

Alyssa D. Fajardo, Catalina Amador-Ortiz, Jonathan Chun, David Stewart, James W. Fleshman

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Introduction. The concept of staple line reinforcement is a growing area of interest. This study evaluated the feasibility and effect of using bioabsorbable Seamguard (BSG) to bolster end-to-end stapled rectal anastomoses in a porcine model. Methods. Eleven female 45-kg Yucatan domestic pigs were used. Each animal served as its own control by creating a BSG and nonreinforced anastomosis using a 29-mm end-to-end anastomotic stapling device. Reinforced anastomoses were randomized to proximal and distal positions along the rectum. Each staple line reinforcement agent consisted of adding BSG to the stapling device according to the manufacturer's instructions. Barium enemas were then performed and the 2 anastomotic sites harvested. Each anastomosis underwent burst testing. The internal diameter of each anastomosis was measured and underwent pathologic review. Results. Bolstered anastomoses offered no strength advantage as burst pressures were no different as compared with unbolstered anastomoses. There was also no difference in anastomotic internal or external diameters. Only 1 stapled anastomosis burst during testing and none in the bolstered group. On histological analysis, there was a significant increase in inflammatory infiltrate in the bolstered group as compared with the stapled group (P =.041), with a higher incidence of lymphocytes (P =.047) and giant cells (P =.037). There was no difference in mucosal loss at the anastomotic site, neovascularization, fibroblast presence, extent of fibrosis, muscle layer disruption, percentage of anastomosis replaced by collagen, and elastin deposition. Conclusions. The routine use of BSG bolsters in stapled rectal anastomoses is safe and results in equivalent anastomotic strength as traditional stapled anastomoses.

Original languageEnglish (US)
Pages (from-to)288-294
Number of pages7
JournalSurgical Innovation
Volume19
Issue number3
DOIs
StatePublished - Sep 1 2012

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Equipment and Supplies
Sus scrofa
Elastin
Feasibility Studies
Giant Cells
Rectum
Fibrosis
Swine
Collagen
Fibroblasts
Lymphocytes
Pressure
Muscles
Incidence
Barium Enema

Keywords

  • Seamguard
  • anastomosis
  • bolster
  • porcine

ASJC Scopus subject areas

  • Surgery

Cite this

Evaluation of bioabsorbable seamguard for staple line reinforcement in stapled rectal anastomoses. / Fajardo, Alyssa D.; Amador-Ortiz, Catalina; Chun, Jonathan; Stewart, David; Fleshman, James W.

In: Surgical Innovation, Vol. 19, No. 3, 01.09.2012, p. 288-294.

Research output: Contribution to journalArticle

Fajardo, Alyssa D. ; Amador-Ortiz, Catalina ; Chun, Jonathan ; Stewart, David ; Fleshman, James W. / Evaluation of bioabsorbable seamguard for staple line reinforcement in stapled rectal anastomoses. In: Surgical Innovation. 2012 ; Vol. 19, No. 3. pp. 288-294.
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