An experimental assessment of suture techniques using Lapra-ty clips through the laparoscope and a case report: laparoscopic closure using Lapra-ty for a perforation of the sigmoid colon.
OBJECTIVE
As endoscopic procedures become various and complicated, it becomes necessary to develop alternative techniques for tissue suture and ligation. We have developed a new suture technique intracorporeal knotting.


METHODS
An 8-cm suture material having a knot on the other side of a needle, was used in laparoscopic surgery. Furthermore, a 5-mm2 Vicryl mesh was pierced as a buttress. The Lapra-ty was used to secure the tissue. Under laparotomy, the forestomach of a male Donryu rat at 6 weeks of age was incised and sutured with 3-0 Vicryl. 3-0 Vicryl was secured with the knot substitute (group A) or three-throw knot (group B) under Nembutal anesthesia. The animals were sacrificed 7 days after operation. Specimens were taken from the forestomach. Those were fixed with 10% formalin and stained with hematoxylin eosin and Elastica Wangieson methods. The histological findings were compared between group A and group B. A successful laparoscopic closure using Lapra-ty is reported in a patient with a perforation of the sigmoid colon.


RESULTS
Microscopically, in this method, neither erosion, ulcer nor microabscess is evidenced. This method may make an intracorporeal knot easy. Also we treated a patient who had a perforation of the sigmoid colon using Lapra-ty. The patient recovered without any trouble.


CONCLUSIONS
This method could make ligation technique much easier and the operating time shorter.
Rino
Yasushi
Y
First Department of Surgery, Yokohama City University School of Medicine, 3-9, Fukuura, Kanazawa-ku, Yokohama City, 236-0004, Japan.
Imada
Toshio
T
Ozawa
Yukihiro
Y
Iwasaki
Hiroyuki
H
Tokunaga
Makoto
M
Morinaga
Soichiro
S
Onodera
Seigo
S
Hatori
Shinsuke
S
Kato
Naoto
N
Takanashi
Yoshinori
Y
D000818:Animals; D006801:Humans; D007416:Intestinal Perforation / Q000601:surgery*; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D051381:Rats; D011919:Rats, Inbred Strains; D012810:Sigmoid Diseases / Q000601:surgery*; D013536:Suture Techniques / Q000295:instrumentation*