title: Safety and efficacy of a novel linear staple device with bioabsorbable polyglicolic acid felt in laparoscopic colorectal surgery.
abstract: BACKGROUND
  Laparoscopic surgery is widely used for the treatment of colorectal cancer, but it is often associated with postoperative anastomotic complications. Generally, gastrointestinal anastomosis for colorectal surgery is performed using mechanical anastomosis with a double stapling technique. Using the automatic suture device with bioabsorbable polyglycolic acid (PGA) felt is expected to adequately reinforce staple lines on fragile tissue, helping to prevent anastomotic complications, including leakage.
  
  
  METHODS
  This study included 17 patients who underwent laparoscopic surgery after a diagnosis of colorectal cancer. The rectosigmoidal colon was resected toward the dentate line with a novel automatic PGA-felt suture device.
  
  
  RESULTS
  None of the patients had any postoperative bleeding, and none developed grade III or higher postoperative complications based on the Clavien-Dindo classification. When the sigmoid colon, rectosigmoid, or rectum was anastomosed, holding the excess portion of the PGA felt, stapled with the automatic PGA-felt suture device, allowed us to adequately maneuver the part of the colon or rectum to be anastomosed. With this technique, we could easily and safely insert and remove the automatic anastomotic device. When the lower rectum was resected in a planned, two-step operation, the orientation of the PGA felt helped to determine the direction in which the automatic suture device was to be inserted in the second step. Thus, the resected rectum could easily be stapled in a straight line.
  
  
  CONCLUSIONS
  The automatic PGA-felt suture device is safe and effective for colorectal resections and anastomoses.
authors: Department of Surgery, Kitasato University School of Medicine, Sagamihara, Japan.
authors: Masanori
authors: M
authors: Naito
authors: Department of Surgery, Kitasato University School of Medicine, Sagamihara, Japan.
authors: Takahiro
authors: T
authors: Yamanashi
authors: Department of Surgery, Kitasato University School of Medicine, Sagamihara, Japan.
authors: Takatoshi
authors: T
authors: Nakamura
authors: Department of Surgery, Kitasato University School of Medicine, Sagamihara, Japan.
authors: Hirohisa
authors: H
authors: Miura
authors: Department of Surgery, Kitasato University School of Medicine, Sagamihara, Japan.
authors: Atsuko
authors: A
authors: Tsutsui
authors: Department of Surgery, Kitasato University School of Medicine, Sagamihara, Japan.
authors: Takeo
authors: T
authors: Sato
authors: Department of Surgery, Kitasato University School of Medicine, Sagamihara, Japan.
authors: Masahiko
authors: M
authors: Watanabe
mesh_terms: D020341:Absorbable Implants; D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical; D057868:Anastomotic Leak / Q000517:prevention & control*; D001672:Biocompatible Materials; D003106:Colon / Q000601:surgery; D015179:Colorectal Neoplasms / Q000601:surgery*; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D011100:Polyglycolic Acid; D012007:Rectum / Q000601:surgery; D013528:Surgical Staplers; D013536:Suture Techniques / Q000295:instrumentation*; D013537:Sutures; D016896:Treatment Outcome
chemical_list: D001672:Biocompatible Materials; D011100:Polyglycolic Acid
keywords: Anastomotic leakage; laparoscopic surgery; surgical stapler