Hand-assisted demucosalized gastrocystoplasty comparing different tissue closure methods.
OBJECTIVE
To perform experiments to determine whether a new tissue sealant (SynthaSeal) could be an alternative for suture closure in minimally invasive bladder autoaugmentation gastrocystoplasty using demucosalized stomach. Alternative methods to suture closure for tissue approximation such as laser tissue welding and fibrin glue have been reported.


METHODS
Minimally invasive autoaugmentation gastrocystoplasty with demucosalized stomach was performed on 14 female mongrel dogs. Two dogs were used to refine the technique. The remaining dogs were assigned to a suture group (n = 6) or a SynthaSeal group (n = 6). Anastomoses were performed using either SynthaSeal or suture. The in vivo bladder volumes and pressures of the groups were measured before and after gastrocystoplasty. The animals were studied on day 14. Samples of the anastomotic area were taken to measure the tensile strength and stress. Histologic analysis was conducted to assess tissue healing. The anastomotic time was recorded for each group.


RESULTS
The tensile strength of the anastomoses in the SynthaSeal group was significantly increased (9.99 +/- 1.14 Newtons) compared with the suture group (5.66 +/- 0.97 Newtons) (P <0.05). The breaking stress comparisons and anastomosis times were equivalent between the two groups. The histologic evaluation revealed minor tissue devitalization and a normal inflammatory response in both groups.


CONCLUSIONS
Minimally invasive gastrocystoplasty using demucosalized stomach can be successfully performed with SynthaSeal tissue sealant. This may provide a reliable alternative to suture closure.
Pareek
G
G
Center for Pediatric Urology and Laboratory for Minimally Invasive Urologic Surgery, Department of Urology, Children's Hospital of New York, Weill Medical College of Cornell University, New York, New York, USA
Specht
M
M
Lin
D D
DD
Petratos
P B
PB
Fahey
T J
TJ
Soslow
R A
RA
Felsen
D
D
Poppas
D P
DP
D000714:Anastomosis, Surgical / Q000295:instrumentation / Q000379:methods; D000818:Animals; D004285:Dogs; D005260:Female; D005753:Gastric Mucosa; D015391:Gastroplasty / Q000379:methods; D008422:Materials Testing; D013270:Stomach / Q000637:transplantation*; D013314:Stress, Mechanical; D013536:Suture Techniques; D013718:Tensile Strength; D014014:Tissue Adhesives; D001743:Urinary Bladder / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*
D014014:Tissue Adhesives