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Is polyglycolic acid (PGA) nonwoven fabric suitable as an anastomotic portion reinforcement material of automatic suturing device? – Comparison with early bioresorbable materials –

Mitsuo Miyazawa, MD, FACS1, Katsuya Okada, MD2, Masayasu Aikawa2, Shunsuke Ohnishi3, Yoshito Ikada4. 1Teikyo University Mizonokuchi Hospital, 2Saitama Medical University International Medical Center, 3Hokkaido University, 4Kyoto University

Background:  Currently, in laparoscopic surgery, a sheet of bioabsorbable material is often used as a stumped closure reinforcement to reinforce the closure of the gastrointestinal tract and pancreatic stump with an automatic suturing device. We compared the bioabsorbable material which decomposes earlier than PGA nonwoven fabric and PGA nonwoven fabric, and evaluated the material of decomposition rate which is more effective as an anastomotic part reinforcement material.

Method: Split 2/3 lap of small intestine of pig and suture with 4 needles of suture. A PGA nonwoven fabric and a bioabsorbable polymer sheet (BAPS) (lactic acid: caprolactone 50: 50 copolymer, absorbed in vivo in about 6 to 8 weeks) which can be hydrolyzed at an early stage are stitched around the sewn portion I wore it. After 1, 3 weeks of suture reopening, the strength of the anastomotic part was examined by the tensile strength test, and the site was compared histologically. (Each n = 3).

Results:  After 1, 3 weeks, no anastomotic site showed suture failure. Compared with PGA, the surrounding anastomotic part of BAPS was harder and thicker palpated. In the tensile strength test, BAPS had the highest tensile strength at 1 week compared to PGA (PGA and BAPS are equivalent at 3 weeks).

Conclusion and Discussion: As early as the anastomotic portion reinforcement material, it was shown that BAPS reinforces the anastomotic site highly in comparison with PGA. As a stump reinforcement material, it is thought that material that absorbs earlier than PGA is suitable.


Presented at the SAGES 2017 Annual Meeting in Houston, TX.

Abstract ID: 92051

Program Number: P643

Presentation Session: Poster Session (Non CME)

Presentation Type: Poster

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