Reconstructive Microsurgery of the Rabbit Oviduct Using Serosal Microsutures and Fibrin Sealant

Abstract

Microsurgical reconstruction of the rabbit oviduct was undertaken utilizing either: A: fibrin sealant in a thick layer applied to two or three serosa microsutures (20 rabbits), B: fibrin sealant only (20 rabbits), and C: microsutures only (20 rabbits). The pregnancy rates and the patency rates of the oviducts showed no significant differences between the three groups. However, the formation of adhesions at the site of reanastomosis was significantly lower and the total duration of surgery significantly shortened when fibrin sealant was employed. It is concluded that fibrin sealant combined with serosa microsutures certainly is the most convenient method in human tubal microsurgery seeing that this method maintains a higher tensil strength at the site of reanastomosis as compared to group B and avoid the risk of mucosal lesions as compared to group C.

Estudo morfológico das entero-anastomoses com suturas em pontos separados complementados com adesivo sintético ou biológico em coelho

“…Ao se comparar a presença deste parâmetro entre os dois grupos, observou-se que houve uma diferença estatisticamente maior no grupo adesivo sintético, em todos os subgrupos (Figura 1). Outros autores 16,17,18,19 realizaram pesquisas com adesivo sintético e biológico nas enteroanastomoses, utilizando o mesmo animal, constataram também menor aderência nos animais do grupo adesivo biológico. Quanto a formação de deiscência, foram observados em ambos os grupos.…”

Sutureless and Reduced Suture Anastomosis of Hollow Vessels With Fibrin Glue: A Review

“…This procedure was executed in rabbits and compared with a pure FG anastomosis and two different suture groups. By moving the stay-sutures from the myosalpinx to the serosa and sealing with FG, postoperative tensile strength at the crucial 3-to 4-day mark was increased, and there were reductions in mucosal lesions during suturing, in adhesion formation, and in operating time [166].…”

“…The tensile stress-strain value of FG anastomoses was less than that for sutured anastomoses on the third postoperative day. Therefore, Sorensen et al [166] suggested that the optimal technique for humans would be a stented anastomosis with no sutures or FG for the myosalpinx. However, two to three serosal microsutures covered with FG should be used, with the stent removed after the FG has cured for 3 min.…”

“…The use of a temporary intraluminal stent was common [31,165,168,169,171,173,174] and was suggested as being essential for dissimilar diameter oviduct stumps [168][169][170][171]. Small to negligible in ammatory response and faster healing [83,86,172] and shorter operating time [165,166,[173][174][175] were reported in many studies for reduced suture-FG and FG (commercial and AFG) when compared with sutured anastomoses. Reduced adhesion formation was described [32,86,165,166,174], as was the absence of intergroup adhesion rate differences [170,173,175].…”

Histomorphological Evaluation of Wound Healing of Rabbit Oviduct after Microsurgical Reanastomosis with the Use of Autologous Fibrin Adhesive, Human Fibrin Adhesive or Poly-Glycolic Acid Suture

“…Our previous experiments [1][2][3] have shown the technical advantages (such as re duced bleeding, reduced operation time and a significant lower adhesion formation) of using fibrin adhesive in reanastomosis of the rabbit oviduct compared to the use of conventional suturing. After a postoperative recovery of 4 weeks, the rate of pregnancy was the same in animals where the reanastomosis was per formed with the use of fibrin adhesive, autol ogous and heterologous, as in animals with PGA-sutured anastomosis and in nonoperated animals [3].…”