title: Staple line reinforcement with new biomaterial increased burst strength pressure: an animal study.
abstract: BACKGROUND
  Most bariatric operations rely on stapler devices. Although today staplers are extremely safe, efficient, and reliable, a potential risk exists for staple line failures, leading to three complications: leaks, fistulas, and bleeding. Porcine small intestinal submucosa strip applied over the staple line suture might help prevent these problems.
  
  
  METHODS
  Forty animals (canine model developed at the University of São Paulo, São Paulo, Brazil) underwent general anesthesia and laparotomy. One nonreinforced staple line suture and one staple line suture reinforced with Surgisis SLR was created in each animal. The burst strength pressure of the 80 staple line sutures was obtained. Suture line bleeding and the ease of use of the membrane were also noted. The data were compared (Student's t test). The dogs were euthanized after the procedure. Two surgeons with experience in stapler devices performed all procedures.
  
  
  RESULTS
  The mean +/- SD burst pressure was 209.26 +/- 76.41 mm Hg and 441.33 +/- 128.64 mm Hg for the stapler line without and with the biodegradable membrane, respectively. The difference was statistically significant (P = .002). No in vivo suture line bleeding occurred. The biodegradable membrane was easy to use.
  
  
  CONCLUSIONS
  The biodegradable membrane was able to increase the burst strength pressure of the bowel segment staple line. It might help prevent some causes of staple line leaks.
authors.affiliation: Center for the Surgical Treatment of Morbid Obesity, Hospital São Camilo, São Paulo, Brazil. jcpinheirofilho@hotmail.com
authors.forename: Jose S
authors.initials: JS
authors.lastname: Pinheiro
authors.forename: Jose L
authors.initials: JL
authors.lastname: Correa
authors.forename: Ricardo V
authors.initials: RV
authors.lastname: Cohen
authors.forename: Jose Augusto
authors.initials: JA
authors.lastname: Novaes
authors.forename: Carlos A
authors.initials: CA
authors.lastname: Schiavon
mesh_terms: D020341:Absorbable Implants; D000818:Animals; D050110:Bariatric Surgery / Q000295:instrumentation*; D001672:Biocompatible Materials; D003094:Collagen; D004285:Dogs; D008365:Manometry; D023421:Models, Animal; D017792:Surgical Stapling / Q000295:instrumentation*; D013552:Swine
chemical_list: D001672:Biocompatible Materials; D003094:Collagen