V-Loc, a new wound closure device for peritoneal closure--is it safe? A comparative study of different peritoneal closure systems.
BACKGROUND
Transabdominal laparoscopic hernia repair is a safe and commonly used procedure for groin hernias. Failure of peritoneal closure is rare but can lead to herniation and bowel obstruction. A new wound closure device named V-Loc was tested in this study. It consists of a barbed absorbable thread that is self-anchoring and eliminates the need to tie a knot. The efficacy of this device in achieving secure peritoneal closure was investigated.


METHODS
In 10 recently deceased patients, peritoneal incisions were set and closed with 5 different devices including V-Loc. Peritoneal thickness was measured prior to testing. A tensiometer was used to apply tensile loads on the peritoneal closure. Tensile loads were measured in Newton at the time of peritoneal rupture or failure of the suture or knot.


RESULTS
Peritoneal thickness had a significant impact on the results (P < .0001). A mean tensile load of 7.41 N was tolerated when the peritoneal thickness was ≤0.25 mm and 15.38 N when the peritoneal thickness was >0.25 mm. Peritoneal rupture was observed more often than failure of closure. The latter occurred more often at high tension and in experiments with tacking or stapling devices than with sutures. While testing V-Loc, peritoneal rupture occurred at 19.85 N, mean, showing significantly better results than AbsorbaTack, extracorporally knotted running suture, or Multifire Endo Hernia Stapler (P < .05).


CONCLUSIONS
The new wound closure device V-Loc is a feasible and promising alternative to common peritoneal closure techniques but is yet to be evaluated in clinical studies.
SMZ Floridsdorf, Vienna, Austria. philipp.patri@wienkav.at
Philipp
P
Patri
Claudia
C
Beran
Josipa
J
Stjepanovic
Simone
S
Sandberg
Albert
A
Tuchmann
Hollinsky
H
Christian
D000368:Aged; D000369:Aged, 80 and over; D002102:Cadaver; D004867:Equipment Design; D004869:Equipment Safety; D005260:Female; D006552:Hernia, Inguinal / Q000601:surgery*; D006801:Humans; D008297:Male; D010537:Peritoneum / Q000601:surgery*; D018709:Statistics, Nonparametric; D013536:Suture Techniques; D013537:Sutures; D013718:Tensile Strength; D058106:Wound Closure Techniques / Q000295:instrumentation*