Biomechanical Analysis of Laparoscopic Incisional Gastropexy With Intracorporeal Suturing Using Knotless Polyglyconate


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Abstract

Objective:To evaluate load to failure of laparoscopic incisional gastropexy performed with intracorporeal suturing using knotless polyglyconate (KP).Study Design:Cadaveric study.Animals:Canine cadavers (n = 12).Methods:Laparoscopic incisional gastropexy using 2 strands of KP was performed in 6 canine cadavers and by an open approach in 6 cadavers. Length of the gastropexy, number of suture bites on each side of the gastropexy, and number of inadvertent full thickness gastric suture bites were recorded. Load to failure was measured.Results:There was no significant difference in mean (±SD) gastropexy load to failure for the open (46.3 ± 19.6 N) and laparoscopic (69.0 ± 26.0 N) approaches (P = .123). No significant differences between laparoscopic and open approaches were detected for mean stomach (3.1 ± 0.1 cm; 3.0 ± 0.2 cm; P = .353) or abdominal wall (3.1 ± 0.2 cm; 3.0 ± 0.2 cm; P = .553) incision lengths. There was no significant difference between groups for number of suture bites medially (P = .448) or laterally (P = .363). There were 3 instances of a single gastric intraluminal suture for the laparoscopic group and none for the open approach (P = .023).Conclusion:Incisional gastropexy performed with laparoscopic intracorporeal suturing and KP has a load to failure that is comparable with an open method. Load to failure was similar to reported values for open incisional gastropexy with knotless glycomer 631.

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