Study on Randomized Clinical Trial Comparing Manual Suture and Different Models of Mechanical Suture in the Mimicking of Bariatric Surgery in Swine

Background: Differences in surgeon ability sparked the development of technologies that, by overcoming individual differences, allow for proper technique execution and the greatest possible final result. A procedure must be replicated consistently by the majority of surgeons in order for it to be adopted and recognised as effective.

The goal of this study was to compare the results of manual sutures vs mechanical sutures in the treatment of gastroenteroanastomosis and enteroanastomosis in swine from the perspective of anatomic pathology utilising different models of linear mechanical staplers.

The researchers employed 36 healthy, adult male Sus scrofa domesticus pigs that weighed between 20.7 and 25.5 kg. Group A, manual suture with Polysorb® 3-0 wire; group B, 80-shear linear stapler (Covidien® Gia 8038-S); group C, 75-shear linear stapler (Ethicon® Tlc 75); and group D, 75-shear linear stapler (Resource® Yq 75-3); and group E, 75-shear linear stapler (Resource® Yq 75-3).

The formation of foreign body granuloma in the gastroenteroanastomosis and enteroanastomosis was observed in 88.9% of the swine that underwent manual suture and none of the swine that underwent stapling during the histopathological analysis. There was also a statistical difference in the degree of inflammation between swine from Group A and those from Groups B, C, and D, with the latter being more extreme in those swine that received manual suture. Closing anastomoses in swine with mechanical sutures provides the advantage of avoiding the need to puncture the intestinal wall within the cavity, reducing the danger of peritoneal cavity contamination, even though the findings were not statistically significant.

Conclusion: Both types of suture promoted proper healing of gastroenteroanastomoses and enteroanastomoses in swine, though there was a higher degree of inflammation and an increased occurrence of foreign body granuloma in swine subjected to manual suture, despite similarities in safety, efficiency, and effectiveness between the models of linear mechanical staplers tested during the performance of these anastomoses on swine.

Author(S) Details

Marcos A. P. Fernandes
Institute of Obesity and Advanced Video Laparoscopic Surgery of Petropolis, Rio de Janeiro, Brazil.

Bruno M. T. Pereira
Division of Trauma, University of Campinas, São Paulo, Brazil.

Sandra M. Guimarães
Institute of Obesity and Advanced Video Laparoscopic Surgery of Petropolis, Rio de Janeiro, Brazil.

Aline Paganelli
Laboratório de Patologia Micron Cell Diagnóstico, Rio de Janeiro, Brazil.

Carlos Manoel C. T. Pereira
Institute of Obesity and Advanced Video Laparoscopic Surgery of Petropolis, Rio de Janeiro, Brazil.

Bruno M. T. Pereira
Division of Trauma, University of Campinas, São Paulo, Brazil.

View Book:- https://stm.bookpi.org/NHMMR-V1/article/view/6188

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