Evaluation of a Transection Method for Distal Pancreatectomy : A Comparative Study on the Use of Electrosurgical and Stapling Devices in Swine

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  • Ikeda Tetsuo
    Center for Integration of Advanced Medicine, Graduate School of Medical Sciences, Kyushu University
  • Akahoshi Tomohiko
    Center for Integration of Advanced Medicine, Graduate School of Medical Sciences, Kyushu University
  • Kawanaka Hirofumi
    Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University
  • Uchiyama Hideaki
    Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University
  • Yamashita Yo-ichi
    Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University
  • Morita Masaru
    Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University
  • Oki Eiji
    Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University
  • Saeki Hiroshi
    Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University
  • Sugimachi Keishi
    Department of Surgery, Kyushu University Beppu Hospital
  • Ikegami Toru
    Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University
  • Yoshizumi Tomoharu
    Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University
  • Soejima Yuji
    Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University
  • Shirabe Ken
    Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University
  • Mimori Koshi
    Department of Surgery, Kyushu University Beppu Hospital
  • Watanabe Masayuki
    Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University
  • Hashizume Makoto
    Center for Integration of Advanced Medicine, Graduate School of Medical Sciences, Kyushu University
  • Maehara Yoshihiko
    Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University

Bibliographic Information

Other Title
  • 膵切離方法の検討 : 動物実験における高周波電気器機と吻合器の比較検討

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Abstract

Background : Despite marked improvements in pancreatic surgery, the high incidence of pancreatic fistula and high morbidity after resection persists. Purposes : The objective of this study was to evaluate the role of electrosurgical and stapling devices as an alternative to traditional methods of stump closure in an animal model of distal pancreatectomy. Methods : Four devices were used for transection of the pancreatic body : a bi-polar thermofusion system attached to an automatic irrigation function (BI, n = 3), a bi-polar tissue sealer (BS, n = 3), an ultrasonic scissor (US, n = 3), and an endoscopic stapling device (ES, n = 3). For each group, burst pressure was tested using an electronic manometer, with a focus on the location (s) of the first disruption (s). Histological examination was performed for the dissected surfaces. The transection line, including staples, was embedded in a polyester resin, and histological examination was performed for these polished sections of the resin. Results : Pressure was significantly higher for BI (P < 0.01) than that for the other devices. In contrast, thermal denaturation of the pancreas parenchyma was observed at a depth of approximately 1 mm from the dissected portion for BS, while it extended beyond 15 mm for BI. The staple line was the first disruption point for all of ES cases. Conclusions : The pellicle of the pancreas is likely to be deficient after a surgical operation. If the pellicle is preserved, the strength of the pellicle may be insufficient for complete closure with high stapling mechanical pressure or the protein coagulation of usually used electrosurgical devices.

Journal

  • 福岡醫學雜誌

    福岡醫學雜誌 104 (12), 515-522, 2013-12-25

    Fukuoka Medical Association

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