Bioabsorbable staple-line reinforcement to reduce staple-line bleeding in the transection of mesenteric vessels during laparoscopic colorectal resection: a pilot study.
BACKGROUND
Staple line hemorrhage and leak are the 2 most dreaded complications of laparoscopyassisted resection of colorectal cancer (LARCC). Recently, anastomotic staple lines have been reinforced with a range of absorbable and non-absorbable bioprosthetic reinforcement materials. This pilot prospective study used the bioabsorbable Seamguard (BSG; WL Gore & Associates, Flagstaff, AZ) for routine reinforcement of the mesenteric vascular staple transection to prevent mesenteric hemorrhage and to assess its safety and feasibility in a consecutive series of laparoscopic colonic resections.


METHODS
Twenty-five patients consecutively scheduled to undergo LARCC were enrolled in the study. All operations were performed with a standard LARCC technique which included loading of the BSG sleeves onto the jaws of the cutter/stapler.


RESULTS
There were 23 wholly LARCC cases and 2 open conversions. BSG was used in all 25 patients. No patient experienced staple-line bleeding or other complications during the surgical procedure. The mean number of staple-line reinforcement sleeves used was 2.6 (range, 2-4). The mean operative time was 118 minutes (range, 65-184 minutes). Additional measures to achieve hemostasis were not required in any case. The mean cost was US 475.20 dollars for the procedure.


CONCLUSIONS
This small pilot study has shown the routine use of BSG mesenteric staple line reinforcement to be safe, quick and effective during LARCC.
de la Portilla
F
F
Coloproctology Unit Department of General Surgery, Hospital Juan Ramón Jiménez, Huelva, Spain. delaportilla@ya.com
Zbar
A P
AP
Rada
R
R
Vega
J
J
Cisneros
N
N
Maldonado
V H
VH
Utrera
A
A
Espinosa
E
E
D020341:Absorbable Implants; D000368:Aged; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D015331:Cohort Studies; D003082:Colectomy; D005260:Female; D006488:Hemostasis, Surgical / Q000295:instrumentation*; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008643:Mesentery / Q000098:blood supply* / Q000601:surgery*; D008875:Middle Aged; D010865:Pilot Projects; D012811:Sigmoid Neoplasms / Q000601:surgery; D017792:Surgical Stapling / Q000009:adverse effects*; D016896:Treatment Outcome