PMID- 18586575
OWN - NLM
STAT- MEDLINE
DCOM- 20090303
LR  - 20081125
IS  - 1550-7289 (Print)
IS  - 1550-7289 (Linking)
VI  - 4
IP  - 6
DP  - 2008 Nov-Dec
TI  - Comparison of permanent and nonpermanent staple line buttressing materials for 
      linear gastric staple lines during laparoscopic Roux-en-Y gastric bypass.
PG  - 729-34
LID - 10.1016/j.soard.2008.02.001 [doi]
AB  - BACKGROUND: Several publications have suggested that staple line buttressing 
      might decrease staple line bleeding, increase burst pressure, and decrease the 
      likelihood of acute failure resulting in leak. Currently, permanent and 
      nonpermanent options are available. However, concern has been raised about the 
      permanent buttress material and its potential for delayed strip expulsion. This 
      study analyzed our experience with 3 different buttressing materials for creating 
      the gastric division during laparoscopic Roux-en-Y gastric bypass. METHODS: From 
      July 5, 2001 to May 30, 2007, 1451 consecutive patients underwent laparoscopic 
      gastric bypass with buttressing material used for the stapled creation of the 
      gastric pouch. Peristrips Dry (PSDs), permanent bovine pericardial strips, were 
      used in 926 cases from July 5, 2001 to October 11, 2005. Seamguards, a synthetic 
      bioabsorbable product, were used in 145 cases from November 2, 2004 to July 18, 
      2006, and PSD Veritas, remodelable, nonpermanent bovine pericardial strips, were 
      placed in 380 patients from October 11, 2005 to May 30, 2007. All products were 
      applied to the 60-mm-long, 3.5-mm cartridges of the EndoGIA II stapler. The ease 
      of use, operative complications, visual bleeding, and postoperative leaks were 
      recorded. RESULTS: The patient characteristics were comparable for all groups. 
      All products were easy to load on the stapler, and no operative complications 
      related to the use of the buttress materials occurred. The incidence and severity 
      of staple line bleeding was not specifically calculated but was visually noted to 
      be minimal in all cases. Of the 3 groups, 4 contained leaks occurred in the 
      Seamguards group, and all were successfully managed nonoperatively. No acute 
      leaks were discovered in the PSD or PSD Veritas groups. This difference was 
      statistically significant (p <.001). CONCLUSION: Neither the PSDs or PSD Veritas 
      group exhibited staple line complications. However, 4 leaks occurred in the 
      patients who had Seamguards incorporated into their gastric pouch linear staple 
      lines.
FAU - Shikora, Scott A
AU  - Shikora SA
AD  - Division of Bariatric Surgery, Tufts-New England Medical Center, Boston, 
      Massachusetts 02111, USA. Sshikora@tufts-nemc.org
FAU - Kim, Julie J
AU  - Kim JJ
FAU - Tarnoff, Michael E
AU  - Tarnoff ME
LA  - eng
PT  - Comparative Study
PT  - Journal Article
DEP - 20080630
PL  - United States
TA  - Surg Obes Relat Dis
JT  - Surgery for obesity and related diseases : official journal of the American 
      Society for Bariatric Surgery
JID - 101233161
RN  - 0 (Biocompatible Materials)
SB  - IM
MH  - Adult
MH  - Animals
MH  - Biocompatible Materials
MH  - Cattle
MH  - Chi-Square Distribution
MH  - Female
MH  - Gastric Bypass/*methods
MH  - Hemostasis, Surgical/methods
MH  - Humans
MH  - *Laparoscopy
MH  - Male
MH  - Middle Aged
MH  - Obesity, Morbid/*surgery
MH  - Pericardium/transplantation
MH  - Postoperative Complications/*prevention & control
MH  - Surgical Stapling/*instrumentation
MH  - Treatment Outcome
EDAT- 2008/07/01 09:00
MHDA- 2009/03/04 09:00
CRDT- 2008/07/01 09:00
PHST- 2007/11/27 00:00 [received]
PHST- 2008/02/05 00:00 [revised]
PHST- 2008/02/07 00:00 [accepted]
PHST- 2008/07/01 09:00 [pubmed]
PHST- 2009/03/04 09:00 [medline]
PHST- 2008/07/01 09:00 [entrez]
AID - S1550-7289(08)00076-2 [pii]
AID - 10.1016/j.soard.2008.02.001 [doi]
PST - ppublish
SO  - Surg Obes Relat Dis. 2008 Nov-Dec;4(6):729-34. doi: 10.1016/j.soard.2008.02.001. 
      Epub 2008 Jun 30.