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Ureteral repair with titanium staples: comparison with suture closure
A K Leppäniemi1, D C Wherry, E Pikoulis
1Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA.
Urology
|May 20, 1998
Summary
Vascular closure staple (VCS) clips offer effective ureterotomy closure, comparable to sutures. This method significantly reduces closure time, making it a faster alternative for surgical procedures.
Area of Science:
- Urology
- Surgical Innovation
- Wound Healing Research
Background:
- Titanium vascular closure staple (VCS) clips were initially designed for microvascular procedures.
- Their efficacy in closing larger tubular structures like the ureter remained largely unstudied.
Purpose of the Study:
- To compare the effectiveness of VCS clips versus traditional sutures for closing longitudinal ureterotomy incisions.
- To evaluate healing outcomes, patency, and potential complications associated with each closure method.
Main Methods:
- Longitudinal ureterotomy incisions (1 cm) were created in 9 pigs.
- Incisions were randomly assigned for closure using either 4-0 polyglactin sutures or VCS clips.
- Outcomes were assessed after 3 months, including patency, leakage, calculus formation, stenosis, and histologic examination.
Main Results:
- VCS clip closure was significantly faster, taking approximately 1/7th the time of suture closure (74±28 vs. 534±182 seconds).
- All ureters remained patent with no leakage, calculus, or stenosis after 3 months.
- Histology showed effective healing without acute inflammation or significant fibrosis for both methods; clip closure showed slightly less lumen narrowing, though not statistically significant.
Conclusions:
- VCS clips provide effective ureterotomy closure, yielding wound healing comparable to suture closure.
- The primary advantage of VCS clips is a substantial reduction in surgical closure time.
- VCS clips represent a viable and time-efficient alternative for ureterotomy repair.