TITLE:
Intestinal Staple Line Reinforcement Using MatriStem
AUTHORS:
Kent C. Sasse, David Warner, Sean M. Ward, Walter Mandeville, Rebecca Evans
KEYWORDS:
Surgical Staples, Extracellular Matrix, Porcine Urinary Bladder Matrix, Surgical Anastomosis, Small Intestine
JOURNAL NAME:
Surgical Science,
Vol.6 No.2,
February
13,
2015
ABSTRACT: Background: Staple line reinforcement material has been
demonstrated to raise the burst pressure threshold after linear intestinal
stapling. Numerous bioprosthetic materials have been utilized in surgical
practice. Porcine urinary bladder matrix (ACell, Inc.) is an extracellular
matrix material derived from porcine bladder used to reinforce surgically
repaired soft tissue, and facilitate the body’s regenerative capacity.
Objective: This study represents the first evaluation of urinary bladder matrix
in gastrointestinal staple line reinforcement. Methods: Pathogen-free pigs
underwent midline laparotomy under general anesthesia. Small intestinal
division was performed with an endoscopic linear stapler. Nineteen intestinal divisions
were performed with urinary bladder matrix staple line reinforcement, and
twenty divisions were unreinforced. Staple lines were then subjected to burst
pressure analysis by intraluminal infusion of dyed Krebs solution at an
infusion rate of 20 ml·min-1 under manometric monitoring.
Upon visible staple line extravasation, intraluminal pressure was recorded.
Results: Intestinal staple lines reinforced with urinary bladder matrix
exhibited significantly higher burst pressure threshold (p