The Use of Bioabsorbable Staple Line Reinforcement for Circular Stapler (BSG ???Seamguard???) in Colorectal Surgery

Abstract

Of all the complications associated with colorectal surgery, the most devastating and constant, despite all techniques being performed properly is anastomotic leakage, especially in left colon and rectal resections with rates as high as 50% when the rectum is involved. In 2005, our center published the preliminary experience with the use of linear staple line reinforcement for colon surgery. The purpose of this paper is to present a series of cases using a new conformation of bioabsorbable reinforcement for circular staplers in 5 patients, 2 patients with rectal cancer, 2 patients with diverticular disease, and 1 patient with sigmoid cancer. These initial data are very promising and has encouraged us to continue using this device on further patients.

Reinforcement Does Not Necessarily Reduce the Rate of Staple Line Leaks After Sleeve Gastrectomy. A Review of the Literature and Clinical Experiences

“…Attempts to optimize the staple line have included oversewing it with suture, covering it with omentum or jejunum, and reinforcing it with an array of materials [4][5][6][7][8]. Reinforcement has been shown in other operations to increase burst pressure and decrease hemorrhage [6][7][8][9][10] but no final answers have been found for leaks. According to the First International Sleeve Consensus [11], surgeons were divided between those who reinforced with buttress material, those who oversewed, and those who did not do either.…”

Early Experience with Intraluminal Reinforcement of Stapled Gastrojejunostomy During Laparoscopic Roux-En-Y Gastric Bypass

“…Franklin et al was credited for the first intraluminal use of glycolide buttressing material in colorectal surgery, where it has shown the capacity to decrease the incidence of leak [9,10]. Nguyen et al hypothesized that buttressing material decreases staple-line bleeding through even redistribution of staple pressure on the tissues [8].…”

“…The extraluminal use of absorbable buttressing material as a method of staple-line reinforcement has been widely employed in various types of surgical anastomosis including bariatric, colorectal [9,10], and thoracic procedures [21]. In RYGBP, several types of buttressing materials have been tried for extraluminal reinforcement of the staple line to decrease the incidence of staple-line leak and bleeding.…”

“…In addition, intraluminal buttressing material has been used successfully in colorectal surgery to prevent leakage of stapled anastomosis [9,10]. To our knowledge, this is the first study to assess the use of intraluminal buttressing material in bariatric surgery.…”

Efficacy and effectiveness of suture bolster with Seamguard®

“…The advent of Seamguard Ò in reinforcement of linear sutures yielded good results, reducing the rate of clinical leaks and anastomotic bleeding, and offering satisfactory anastomoses [3][4][5]. The application of Seamguard Ò to circular staplers ensued and yielded the same good results [6]. Further applications in the strategy of reinforcement of linear sutures have been use of Seamguard Ò for lung resections [7], appendectomy [8], bariatric surgery [9], and gastric surgery [10,11].…”