title: BioGlue and Dermabond save time, leak less, and are not mechanically inferior to two-layer and modified one-layer vasovasostomy.
abstract: OBJECTIVE
  To compare operative time, patency, and integrity of glue-assisted versus suture-only vasovasostomies.
  
  
  METHODS
  A Medline search revealed no vasovasostomy studies testing tissue adhesives other than fibrin. We compare glue-reinforced to suture-only vasovasostomies.
  
  
  METHODS
  An academic medical center.
  
  
  METHODS
  None.
  
  
  METHODS
  Using bull vas deferens, we performed: [1] two-layer anastomoses, [2] modified one-layer anatomoses, and [3] Bioglue, Dermabond, or CoSeal-reinforced anastomoses supported by three transmural sutures.
  
  
  METHODS
  Operative times were recorded, patency verified, and microscopic dissection performed to rule out luminal glue intravasation. Destructive mechanical testing was then completed with statistical comparison of load to failure, displacement to failure, and linear stiffness.
  
  
  RESULTS
  Operative time was greatest for two-layer anastomoses and significantly reduced for all three glue-reinforced three-suture anastomoses. All techniques were patent and free of glue intravasation. BioGlue and Dermabond demonstrated greater integrity than all other techniques. Mechanically, BioGlue and Dermabond were superior to both the unreinforced three stitch and CoSeal groups and were capable of resisting higher loads before failure.
  
  
  CONCLUSIONS
  Glue-reinforced anastomoses are significantly less time consuming than traditional techniques. BioGlue and Dermabond have greater mechanical integrity and may be superior to both CoSeal and the sutured techniques.
authors.affiliation: Center for Biomedical Engineering, University of Kentucky, Wenner-Gren Research Laboratory, Lexington, Kentucky, USA.
authors.forename: Marnie M
authors.initials: MM
authors.lastname: Saunders
authors.forename: Z Chad
authors.initials: ZC
authors.lastname: Baxter
authors.forename: Ashraf
authors.initials: A
authors.lastname: Abou-Elella
authors.forename: Allen R
authors.initials: AR
authors.lastname: Kunselman
authors.forename: J C
authors.initials: JC
authors.lastname: Trussell
mesh_terms: D000818:Animals; D002417:Cattle; D003487:Cyanoacrylates / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D008422:Materials Testing; D011506:Proteins / Q000009:adverse effects / Q000627:therapeutic use*; D013314:Stress, Mechanical; D013536:Suture Techniques; D013997:Time Factors; D014014:Tissue Adhesives / Q000009:adverse effects / Q000627:therapeutic use*; D014649:Vas Deferens / Q000601:surgery*; D014669:Vasovasostomy / Q000009:adverse effects / Q000379:methods*
chemical_list: C472676:Bio-glue; D003487:Cyanoacrylates; D011506:Proteins; D014014:Tissue Adhesives; C100832:octyl 2-cyanoacrylate