Ex Vivo Biomechanical Comparison of 4 Suture Materials for Laparoscopic Bladder Closure in the Horse.

This study compares the efficiency of a knotless, barbed suture to the standard suture technique used in laparoscopic bladder repair in horses. Its results suggest that the knotless, barbed suture may be an efficient alternative but further in vivo testing is needed.

Method of the research

This study was carried out on 42 equine cadaver bladders.

• A 5-cm incision was made and repaired in a laparoscopic training box using four different types of suture materials.
• Groups 1 and 2 implemented 2-0 poliglecaprone and 2-0 glycomer knotless, barbed sutures respectively, using laparoscopic instruments.
• Groups 3 and 4 utilized 0 and 2-0 polyglyconate knotless, barbed sutures respectively, using an automated laparoscopic suturing device.
• All groups used a double-layer inverting pattern for the sutures. The time to place the sutures was recorded.
• Following the suturing, the bladders were inflated with water and the pressures at which they burst were recorded including a control group of intact bladders.
• The significant level was set at P<.05 and a statistical analysis with a linear model that accommodates unequal variances was carried out, followed by a post-hoc Tukey's test.

Findings of the research

As per the research,

• The strength at which the sutured bladders burst did not show significant variation among the different suture techniques.
• However, the bursting strength of all treated groups was significantly less than the control group of intact bladders (P<.001).
• The time required to place sutures in the case of the automated suture device groups was significantly less than the groups that employed laparoscopic needle holders and forceps for suture placement.

Conclusions of the research

The study concludes that knotless, barbed suture may potentially be a viable alternative to the standard suture material for closing the urinary bladder in horses following laparoscopy. However, it suggests that further cyclic and in vivo testing should be performed before adopting this method in clinical cases.