TitleUse of a bipolar sealing device to seal partial cystectomy with and without augmentation with a single-layer simple continuous suture pattern in an ex vivo canine model.
Publication TypeJournal Article
Year of Publication2020
AuthorsScharf, VF, Milovancev, M, Townsend, KL, Luff, JA
JournalVet Surg
Volume49
Issue5
Pagination1043-1051
Date Published2020 Jul
ISSN1532-950X
KeywordsAnimals, Cadaver, Cystectomy, Dogs, Male, Neurosurgical Procedures, Pressure, Surgical Equipment, Sutures, Urethra, Urinary Bladder
Abstract

OBJECTIVE: To evaluate the ability of a bipolar sealing device (BSD) to seal canine bladder tissue and to determine the influence of suture augmentation on resistance to leakage of sealed partial cystectomies.

STUDY DESIGN: Ex vivo, simple randomized study.

SAMPLE POPULATION: Urinary bladders harvested from canine cadavers (n = 23).

METHODS: Partial cystectomy of the cranial third of each bladder was performed with a BSD. This seal was augmented with a simple continuous pattern of 4-0 polydioxanone in half of the specimens. A pressure transducer inserted through the ureter measured intraluminal pressure at initial leakage and catastrophic failure as dyed saline was infused via a catheter inserted through the urethra. Initial leakage pressure and pressure at catastrophic failure were compared between sutured and nonsutured sealed partial cystectomies.

RESULTS: Sutured sealed cystectomies showed initial leakage at lower pressures compared to non-sutured cystectomies (8.6 vs. 17.7 mm Hg; P = .0365) but were able to sustain greater pressures at catastrophic failure (34.3 vs. 21.8 mm Hg; P = .007). Catastrophic failure occurred along the seam of all nonsutured sealed cystectomies and at the suture holes in 10 of the 12 sutured bladders.

CONCLUSION: Partial cystectomies were effectively sealed with a BSD in this canine cadaveric bladder model. Augmentation with a simple continuous suture pattern increased the pressure at which catastrophic leakage occurred but lowered initial leak pressure.

CLINICAL SIGNIFICANCE: This study provides evidence supporting the evaluation of BSD use for partial cystectomy in live animals.

DOI10.1111/vsu.13443
Alternate JournalVet Surg
PubMed ID32386271
PubMed Central IDPMC7321922
Grant ListK01 OD023219 / OD / NIH HHS / United States