Skip to main content

Advertisement

SpringerLink
Log in

The application of the V-Loc closure device for gastrointestinal sutures: a preliminary study

  • Published:
Surgical Endoscopy Aims and scope Submit manuscript

Abstract

Background

Leakage is one of the major complications in gastrointestinal surgery. This preliminary study compared a new barbed absorbable thread for gastrointestinal sutures with monofil suture material in a cadaver model.

Methods

In this study, mechanical experiments were performed in 20 recently deceased individuals. Incisions were made in the small intestine, colon, and stomach, and then sutures were created with the V-Loc closure device and monofil suture material. Intestinal bursting pressure was measured by inserting a balloon and slowly filling it with air until there was a dehiscence, or wall or suture rupture.

Results

The bursting pressures differed significantly between the two sutures in the small intestine, showing the advantage of the V-Loc closure device, which had a mean bursting pressure of 116.2 mmHg compared with 110 mmHg for the monofil suture (p = 0.003). The mean bursting pressure did not differ significantly between the two sutures in the colon and the stomach. The mean bursting pressures for the V-Loc closure device were 141.3 mmHg (stomach) and 137.2 mmHg (colon) compared with the monofil suture material bursting pressures of 133 mmHg (stomach) and 134.8 mmHg (colon).

Conclusions

Because the bursting strength of the sutures created with monofil suture material differs significantly from that of the V-Loc closure device, the V-Loc suture material should be used for gastrointestinal sutures. Although the two sutures did not differ significantly in the colon or the stomach, the V-Loc closure device should be used for these as well because its advantages may overrule those of the monofil suture. No knot tying is required, and the operating time can be shorter. Especially for laparoscopic surgery, the V-Loc closure device is recommended.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Mohr Z, Willis S (2010) Intestinal anastomoses and techniques in the lower gastrointestinal tract. Chirurg 67:1–7

    Google Scholar 

  2. Hyman N, Manchester TL, Osler T, Burns B, Cataldo PA (2007) Anastomotic leaks after intestinal anastomosis: it’s later than you think. Ann Surg 245:254–258

    Article  PubMed  Google Scholar 

  3. Komen N, van der Wal HC, Ditzel M, Kleinrensik GJ, Jeekel H, Lange JF (2009) Colorectal anastomotic leakage: a new experimental model. J Surg Res 155:7–12

    Article  PubMed  Google Scholar 

  4. Hope W, Zerey M, Schmelzer TM, Newcomb WL, Paton BL, Heath JJ, Peindl RD, Norton HJ, Lincourt AE, Heniford BT, Gersin KS (2009) A comparison of gastrojejunal anastomoses with or without buttressing in a porcine model. Surg Endosc 23:800–807

    Article  PubMed  Google Scholar 

  5. Ozel SK, Kazez A, Akpolat N (2006) Does a fibrin-collagen patch support early anastomotic healing in the colon? An experimental study. Tech Coloproctol 10:233–236

    Article  PubMed  CAS  Google Scholar 

  6. Anwar S, Hughes S, Eadie AJ, Scott NA (2004) Anastomotic technique and survival after right hemicolectomy for colorectal cancer. Surgeon 2:277–280

    Article  PubMed  CAS  Google Scholar 

  7. Lustosa SA, Matos D, Atallah AN, Castro AA (2002) Stapled versus hand-sewn methods for colorectal anastomosis surgery: a systematic review of randomized controlled trials. Sao Paulo Med J 120:132–136

    Article  PubMed  Google Scholar 

  8. Offodile AC II, Feingold DL, Nasar A, Whelan RL, Arnell TD (2010) High incidence of technical errors involving the EEA circular stapler: a single-institution experience. J Am Coll Surg 210:331–335

    Article  PubMed  Google Scholar 

  9. Zoedler T, Becker H, Roeher HD (1995) Continuous single-layer anastomosis as the standard procedure in the gastrointestinal tract. Chirurg 66:50–53

    PubMed  CAS  Google Scholar 

  10. Stumpf M, Klinge U, Mertens PR (2004) Anastomotic leakage in the gastrointestinal tract: repair and prognosis. Chirurg 75:1056–1062

    Article  PubMed  CAS  Google Scholar 

  11. Demyttenaere SV, Nau P, Henn M, Beck C, Zaruby J, Primavera M, Kirsch D, Miller J, Liu JJ, Bellizzi A, Melvin WS (2009) Barbed suture for gastrointestinal closure: a randomized control trial. Surg Innov 16:237–242

    Article  PubMed  Google Scholar 

  12. Tewari AK, Srivastava A, Sooriakumaran P, Slevin A, Grover S, Waldman O, Rajan S, Herman M, Berryhill R Jr, Leung R (2010) Use of a novel absorbable barbed plastic surgical suture enables a “self-clinching” technique of vesicourethral anastomosis during robot-assisted prostatectomy and improves anastomotic times. J Endourol 24:1645–1650

    Article  PubMed  Google Scholar 

  13. Bush CM, Prosser JD, Morrison MP, Sandhu G, Wenger KH, Pashley DH, Birchall MA, Postma GN, Weinberger PM (2012) New technology applications: knotless barbed suture for tracheal resection anastomosis. Laryncoscope 122:1062–1066

    Article  Google Scholar 

  14. Patri P, Beran C, Stjepanovic J, Sandberg S, Tuchmann A, Hollinsky C (2011) V-Loc, a new wound closure device for peritoneal closure—Is it safe? A comparative study of different peritoneal closure systems. Surg Innov 18:145–149

    Article  PubMed  Google Scholar 

  15. Kennedy GD, Heise C, Rajamanickam V, Harms B, Foley EF (2009) Laparoscopy decreases postoperative complication rates after abdominal colectomy: results from the national surgical quality improvement program. Ann Surg 249:596–601

    Article  PubMed  Google Scholar 

  16. Tong DK, Law WL (2007) Laparoscopic versus open right hemicolectomy for carcinoma of the colon. JSLS 11:76–80

    PubMed  Google Scholar 

  17. Weeks JC, Nelson H, Gelber S, Sargent D, Schroeder G (2002) Short-term quality-of-life outcomes following laparoscopic-assisted colectomy vs open colectomy for colon cancer: a randomized trial. JAMA 287:321–328

    Article  PubMed  Google Scholar 

  18. Fleshman J, Sargent DJ, Green E, Anvari M, Stryker SJ, Beart RW Jr, Hellinger M, Flanagan R Jr, Peters W, Nelson H (2007) Laparoscopic colectomy for cancer is not inferior to open surgery based on 5-year data from the COST study group trial. Ann Surg 246:655–662

    Article  PubMed  Google Scholar 

  19. Tiwari MM, Reynoso JF, High R, Tsang AW, Oleynikov D (2010) Safety, efficacy, and cost-effectiveness of common laparoscopic procedures. Surg Endosc 25(4):1127–1135

    Article  PubMed  Google Scholar 

  20. Luglio G, Nelson H (2010) Laparoscopy for colon cancer: state of the art. Surg Oncol Clin North Am 19:777–791

    Article  Google Scholar 

Download references

Disclosures

Elena Nemecek, Lukas Negrin, Claudia Beran, Romina Nemecek, and Christian Hollinsky have no conflicts of interest or financial ties to disclose.

Author information

Authors and Affiliations

  1. Department for Orthopaedics and Orthopaedic Surgery, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria

    Elena Nemecek

  2. Department for Traumatology, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria

    Lukas Negrin

  3. Department for Surgery, Sozialmedizinisches Zentrum Floridsdorf, Hinaysgasse 1, 1210, Vienna, Austria

    Claudia Beran & Christian Hollinsky

  4. Department for Dermatology, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria

    Romina Nemecek

Authors
  1. Elena Nemecek
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Lukas Negrin
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Claudia Beran
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Romina Nemecek
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Christian Hollinsky
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Elena Nemecek.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Nemecek, E., Negrin, L., Beran, C. et al. The application of the V-Loc closure device for gastrointestinal sutures: a preliminary study. Surg Endosc 27, 3830–3834 (2013). https://doi.org/10.1007/s00464-013-2982-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00464-013-2982-8

Keywords

Search

Navigation