The use of staple-line reinforcement during laparoscopic gastric bypass.
Divided linear staple-lines are a mainstay of gastrointestinal surgery, and in particular, bariatric surgery. Staple-line failure, although uncommon, can result in significant morbidity and even mortality. Staple-line buttressing has been developed to improve staple-line strength, decrease bleeding and minimize the risk of leak. Many different products are currently available. However, most have not been proven in clinical trials. Bovine pericardial strips (BPS) are a buttressing material that fits onto the stapler device and gets "stapled" onto the tissue when the device is fired. The strips add thickness and potentially strength to the staple-line. Animal research has shown that staple-lines incorporated with BPS had higher burst pressures than those without. Human experience has suggested that BPS decreased the risk of acute staple-line failures in laparoscopic Roux-en-Y gastric bypass surgery. This report reviews the clinical and research experience with this product.
Shikora
Scott A
SA
Tufts University School of Medicine, Director Division of Bariatric Surgery, Tufts-New England Medical Center, Boston, MA 02111, USA. sshikora@tufts-nemc.org
D000713:Anastomosis, Roux-en-Y / Q000009:adverse effects / Q000379:methods; D000818:Animals; D002417:Cattle; D004195:Disease Models, Animal; D005500:Follow-Up Studies; D015390:Gastric Bypass / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D007431:Intraoperative Complications / Q000517:prevention & control; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D009767:Obesity, Morbid / Q000175:diagnosis / Q000601:surgery*; D010496:Pericardium / Q000637:transplantation; D011446:Prospective Studies; D011817:Rabbits; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D013524:Surgical Flaps; D017792:Surgical Stapling / Q000009:adverse effects / Q000379:methods*; D013537:Sutures; D013718:Tensile Strength; D016896:Treatment Outcome