[Value of absorbable stapling in digestive surgery? Experimental study comparing TA metallic stapling, TA absorbable...

Area of Science:

• Gastrointestinal Surgery
• Biomaterials Science
• Surgical Innovation

Background:

• Absorbable staples offer potential advantages but lack evaluation in gastro-intestinal surgery.
• Current metallic staples are widely used but have limitations.

Purpose of the Study:

• To assess the feasibility and benefits of Lactomer absorbable staples compared to metal staples and polyglactin sutures for intestinal closure.
• To evaluate the wound healing process and complication rates associated with different intestinal closure techniques.

Main Methods:

• A comparative experimental study involving 9 dogs undergoing double Roux en Y loop procedures.
• Intestinal ends were closed using metal staples, Lactomer absorbable staples, or polyglactin sutures.
• Suture samples were analyzed macroscopically and histologically at 10, 25, and 130 days post-operation.

Main Results:

• Absorbable staples led to significant inflammatory adhesions and two cases of fistula formation.
• Histological examination revealed greater tissue trauma and prolonged inflammation around absorbable staples compared to metal staples.
• Metal staples were well-tolerated, showing minimal inflammatory response.

Conclusions:

• Lactomer absorbable staples demonstrated inferior performance with higher complication rates and inflammation compared to metal staples.
• The design differences between staple types influence the healing process and tissue response.
• Metal stapling remains superior for gastro-intestinal surgery; further development is required for reliable absorbable staple use.