title: Knot-tying force during suturing and wound healing in the gastrointestinal tract.
abstract: BACKGROUND
  Objective data should be obtained to determine the most suitable knot-tying force for appropriate suturing during robotic surgery. The purpose of this study was to estimate the appropriate force by investigating the efficiency of wound healing in the gastrointestinal tract in dog models.
  
  
  METHODS
  We cut and sutured the stomach and jejunum of 12 beagles, using different magnitudes of knot-tying forces. The relationship between the knot-tying force and variations in the density of the microvessels and basic-fibroblast growth factor (bFGF)-positive cells were evaluated.
  
  
  RESULTS
  On the 7th postoperative day (POD) in the stomach, and the 7th and 11th POD in the jejunum, the density of the microvessels in the submucosa at the sites of cutting and ligation was higher for the knot-tying force of 1.5 N than for any other forces used. On the 4th and 7th POD in the stomach and 11th POD in the jejunum, the density of bFGF-positive cell in the mucosa was higher for the knot-tying force of 1.5 N than for any of the other forces used.
  
  
  CONCLUSIONS
  By assessing the efficiency of wound healing, it was determined that the knot-tying force of 1.5 N may be the most appropriate for optimal wound healing in the gastrointestinal tract of the beagles.
authors.affiliation: Department of Surgery, School of Medicine, Keio University, Tokyo, Japan.
authors.forename: Junya
authors.initials: J
authors.lastname: Oguma
authors.forename: Soji
authors.initials: S
authors.lastname: Ozawa
authors.forename: Yasuhide
authors.initials: Y
authors.lastname: Morikawa
authors.forename: Toshiharu
authors.initials: T
authors.lastname: Furukawa
authors.forename: Yuko
authors.initials: Y
authors.lastname: Kitagawa
authors.forename: Masakazu
authors.initials: M
authors.lastname: Ueda
authors.forename: Masaki
authors.initials: M
authors.lastname: Kitajima
mesh_terms: D000818:Animals; D013505:Digestive System Surgical Procedures; D004285:Dogs; D016222:Fibroblast Growth Factor 2 / Q000378:metabolism; D005753:Gastric Mucosa / Q000378:metabolism; D007150:Immunohistochemistry; D007413:Intestinal Mucosa / Q000098:blood supply / Q000378:metabolism / Q000601:surgery; D007511:Ischemia / Q000473:pathology / Q000517:prevention & control*; D007583:Jejunum / Q000098:blood supply / Q000378:metabolism / Q000601:surgery; D008297:Male; D008833:Microcirculation; D011183:Postoperative Complications / Q000473:pathology / Q000517:prevention & control*; D012371:Robotics; D013270:Stomach / Q000098:blood supply / Q000601:surgery; D013314:Stress, Mechanical; D013536:Suture Techniques; D014945:Wound Healing
chemical_list: D016222:Fibroblast Growth Factor 2