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A Journal on Surgery
Indexed/Abstracted in: EMBASE, Scopus, Emerging Sources Citation Index
Chirurgia 1999 February;12(1):35-40
Colonic segment resection with a combined laparoscopic endoscopic technique and fibrin glue anastomosis. Experimental study in the pig
Ussia G., Cuccomarino S., Ravo B., Galletti G.
Aim. To evaluate the feasibility of colonic anastomosis after laparoscopic resection using fibrin glue.
Methods. This study has been carried out in the Institute of Experimental Surgery, Department of Surgery, Reanimation and Transplantation ''A. Valsalva'', of the University of Bologna, Italy. Ten pigs underwent laparoscopic operation: after freeing the colonic segment to be resected, a vein stripper was introduced from the anus and its head was secured with a single stitch to the proximal extremity of the isolated colonic segment. Pulling out the vein stripper, the isolated colonic segment was intussuscepted; the anastomotic area was secured with three absorbable single stitches, and then coated with four cc of fibrin glue (Tissucol®, Immuno). After five minutes, the intussuscepted segment was resected with a wire loop introduced from the anus with a colonoscope. The anastomosis was checked under water by endoscopic insufflation. The animals were sacrificed at days 30, 60 and 90.
Results. All the animals survived the operation and were sacrificed at the established time. Macroscopically, the anastomosis appeared substenotic in four cases, and in one case there was a dehiscence corresponding to one suture stitch. Microscopically, after 90 days there was a complete restitutio ad integrum of the colonic wall.
Conclusions. The fibrin glue is effective in laparoscopic colonic anastomosis.