Evaluation of intestinal wall closure using vessel-sealing technology versus conventional closure: an in vivo study.

Abstract

Purpose: Anastomotic leakage is a major postoperative complication of colorectal surgery. LigaSure™ is used commonly for vessel-sealing, but its use for intestinal anastomosis or closure, particularly the healing process, is underreported. We conducted this study to evaluate the feasibility of using LigaSure™ for intestinal wall closure, compared with hand-sewn methods.

Methods: We performed intestinal wall closure of the cecum in rat laparotomy procedures, dividing subjects into a LigaSure™ group (LS) and a hand-sewn group (HS). We compared operation times, tissue structure changes, and pressure resistance from immediately post-operatively to postoperative day (POD) 14.

Results: No postoperative dehiscence or mortality occurred in either group. The LS group required significantly less closure time (113 s) than the HS group (321 s, p < 0.001). The adhesion rates for a midline incision were not significantly different between the groups (LS: 26.7% vs. HS: 6.7%; p = 0.142), with adhesions at the closure site seen in all subjects. The LS group had a lower burst pressure than the HS group until POD 3, with no significant differences thereafter. Structural continuity was established by POD 5 in both groups.

Conclusions: LigaSure™ provides effective intestinal wall closure with a more distinct healing process than with hand-sewn methods, suggesting the potential for staple-free anastomosis.