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Evaluation of automated staple sizes on gastric layer incorporation and intraluminal pressure for partial gastrectomy closure in an ex vivo canine model. | LitMetric

AI Article Synopsis

  • The study assessed the efficacy of different automated staple sizes during a surgical procedure on cadaver dogs, focusing on their ability to create strong closures in partial gastrectomy.
  • Results showed that the smaller 3.5 mm staple cartridge provided significantly higher initial and maximal leakage pressures compared to the larger 4.8 mm cartridge.
  • Both staple sizes effectively incorporated all layers of the stomach tissue, with no significant differences noted in the shape of the staples formed, indicating that in vivo studies are needed to explore their effects on healing and recovery.

Article Abstract

Objective: To evaluate the performance of automated staple sizes on a cadaveric canine partial gastrectomy model.

Methods: Stomachs were transected through the gastric body axis and randomly allocated to two closure groups: Group B, thoracoabdominal (TA) stapler 3.5 mm staple cartridge (blue); Group G, TA stapler 4.8 mm staple cartridge (green). After construct completion, leak testing was performed for both groups and compared. Initial leakage pressure (ILP), maximal leakage pressure (MLP) and leakage location were recorded. Staple lines were evaluated by direct observation and fluoroscopy to assess sub-mucosal layer incorporation and staple conformation. Staple shape was classified as optimal or suboptimal. Significance was set at p less than 0.5.

Results: Following gastrectomy, the mean double gastric wall thickness was 7.82 ± 2.05 mm at the gastric body. Mean ILP was significantly lower in groups G (17.13 ± 1.19 mmHg) compared to group B (50.46 ± 6.03 mmHg, p = 0.0013). Similarly, mean MLP was significantly lower in group G (21.41 ± 1.39 mmHg) compared to group B (64.61 ± 10.21 mmHg, p < 0.0001). Although group G had higher percentage of B-shaped staple formation compared to group B, this was not significant (group G; 92.38%, group B; 54.56%; p = 0.054).

Conclusion: The 3.5 mm TA staple cartridge (blue) achieved superior bursting pressures compared with the 4.8 mm TA staple cartridge (blue) for the closure of a canine partial gastrectomy model. Both staple sizes incorporated all gastric layers. No differences were noticed in optimal staple conformation between groups. In vivo investigation is warranted to evaluate the use of different staple sizes on gastric tissue perfusion, successful healing and post-operative stasis and dehiscence.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10650250PMC
http://dx.doi.org/10.1002/vms3.1294DOI Listing

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