Hand-assisted demucosalized gastrocystoplasty comparing different tissue closure methods

Objectives. To perform experiments to determine whether a new tissue sealan t (SynthaSeal) could be an alternative for suture closure in minimally inva sive bladder autoaugmentation gastrocystoplasty using demucosalized stomach . Alternative methods to suture closure for tissue approximation such as la ser tissue welding and fibrin glue have been reported. Methods. Minimally invasive autoaugmentation gastrocystoplasty with demucos alized stomach was performed on 14 female mongrel dogs. Two dogs were used to refine the technique. The remaining dogs were assigned to a suture group (n = 6) or a SynthaSeal group (n = 6). Anastomoses were performed using ei ther SynthaSeal or suture. The in vivo bladder volumes and pressures of the groups were measured before and after gastrocystoplasty. The animals were studied on day 14. Samples of the anastomotic area were taken to measure th e tensile strength and stress. Histologic analysis was conducted to assess tissue healing. The anastomotic time was recorded for each group. Results. The tensile strength of the anastomoses in the SynthaSeal group wa s significantly increased (9.99 +/- 1.14 Newtons) compared with the suture group (5.66 +/- 0.97 Newtons) (P <0.05). The breaking stress comparisons an d anastomosis times were equivalent between the two groups. The histologic evaluation revealed minor tissue devitalization and a normal inflammatory r esponse in both groups. Conclusions. Minimally invasive gastrocystoplasty using demucosalized stoma ch can be successfully performed with SynthaSeal tissue sealant. This may p rovide a reliable alternative to suture closure. (C) 2001, Elsevier Science Inc.