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To Assess the Effect of Intraperitoneal Cut Suture Ends in Pediatric Minimally Invasive Surgery - A Study in Wistar
Sandesh Parelkar1, Sonal Jitendra Malviya1, Beeejal Sanghvi1
1Department of Pediatric Surgery, Seth GS Medical College and KEM Hospital, Mumbai, Maharashtra, India.
Background:
Advanced minimal access surgery involves extensive intracorporeal suturing and results in a lot of cut suture ends in the operative field. The time and energy spent in retrieving these can be saved in case these cut ends can be left behind safely.
Aim:
The aim of this study was to assess the effect of intraperitoneal cut suture ends in pediatric minimally invasive surgery, a study in wistar rats.
Materials And Methods:
This is an experimental model in which Wistar rats were subjected to laparotomy, and cut suture ends were placed intraperitoneally. Eighteen adult Wistar rats were divided in three groups with 6 rats in each group. Suture used in Group 1 braided absorbable suture material (polyglycolic acid), Group 2 braided nonabsorbable suture material (polyester), and in Group 3 nonbraided nonabsorbable suture material (monofilament polyamide). Depending upon their group, suture material was introduced and left intraperitoneally under anesthesia. The abdominal wall of rats in all groups was closed in a single layer with nonbraided absorbable suture material (poliglecaprone 25). All animals were sacrificed after 4 weeks. The degree of inflammatory reaction in the peritoneal cavity was assessed.
Results:
There were no morbidity or mortality. The rate of adhesions found in the Group II (4 out of 6) was significantly higher (P < 0.0001) than the rate observed in the Group I (2 out of 6) and Group III (none out of 6).
Conclusion:
This pilot study concludes that depending on the type of suture materials used, braided suture materials preferably be removed. We can safely leave behind the cut ends of suture materials intraperitoneally. This will help save time and effort during advanced and prolonged laparoscopic surgeries. Further studies, including study of histology to quantify, are needed.
