title: A quick and simple method to close vascular, biliary, and urinary tract incisions using the new Vascular Closure Staples: a preliminary report.
abstract: Traditional suture reconstruction of tubular organs creates a perforating needle injury, leaves suture material on the endothelial or mucosal surfaces, and is cumbersome when done endoscopically. One alternative method of reconstruction of tubular organs could use the new nonpenetrating clip to create an everted closure. In five pigs, a longitudinal incision of the infrarenal aorta, inferior vena cava, left ureter, gallbladder, and the common bile duct (in two) was closed with Vascular Closure Staples (VCS-clips). Four weeks after surgery, all ten blood vessels remained patent with no thrombosis. There was a well-healed wound with continuous intimal layer. The ureteral, gallbladder, and common bile duct wounds healed without leakage or obstruction in all animals. There was complete mucosal bridging of the wound, although in some specimens one or two clips were exposed to the lumen. The VCS-clips are easily and quickly applied and are safe insofar as can be determined by short-term follow-up.
authors.affiliation: Department of Surgery, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD 20814-4799, USA.
authors.forename: A K
authors.initials: AK
authors.lastname: Leppäniemi
authors.forename: D C
authors.initials: DC
authors.lastname: Wherry
authors.forename: R G
authors.initials: RG
authors.lastname: Soltero
authors.forename: E
authors.initials: E
authors.lastname: Pikoulis
authors.forename: H V
authors.initials: HV
authors.lastname: Hufnagel
authors.forename: N
authors.initials: N
authors.lastname: Fishback
authors.forename: N M
authors.initials: NM
authors.lastname: Rich
mesh_terms: D000818:Animals; D003135:Common Bile Duct / Q000473:pathology / Q000601:surgery*; D005704:Gallbladder / Q000473:pathology / Q000601:surgery*; D009131:Muscle, Smooth, Vascular / Q000473:pathology / Q000601:surgery*; D013528:Surgical Staplers; D013536:Suture Techniques; D013552:Swine; D014025:Titanium; D014513:Ureter / Q000473:pathology / Q000601:surgery*; D014945:Wound Healing / Q000502:physiology
chemical_list: D014025:Titanium