Ex vivo comparison of single-layer and double-layer laparoscopic closure of equine bladders with 2 types of barbed sutures.

The research compared the effectiveness of single-layer and double-layer laparoscopic closure methods of equine bladder incisions with two types of barbed sutures, unidirectional and bidirectional. The study concluded both techniques and suture types to be adequate for laparoscopic closure of the bladder in adult horses.

Research Procedure

• The research conducted was an experimental, ex vivo, surgical study using thirty adult equine cadaver urinary bladders.
• The bladders were randomly divided into five groups. This included intact controls, those sutured with either unidirectional or bidirectional barbed sutures in a single-layer closure, and the same two categories using a double-layer closure.
• A 5-cm apical incision was created in each bladder assigned to a suture group, before they were closed using a laparoscopic trainer.
• In order to measure bursting pressures (BPs), these bladders were filled with saline until they reached their failure point.

Data Analysis

• Comparison of continuous variables among groups employed generalized linear models, combined with post hoc testing.
• Meanwhile, Fisher’s exact test was used to compare categorical variables.
• All statistical significance was set at P < .05.
• Despite the different treatment groups, there was no notable difference in BP. All failed at pressures lower than the intact bladders.
• The 95% confidence interval for BPs surpassed a physiologically significant line of 30 mm Hg post single-layer or double-layer closure.
• Across all treatment groups, surgical time decreased with surgeons’ increasing experience.
• Moreover, the rate of this reduction was more notable for single-layer closures.

Conclusions

• The study concluded from the accumulated data that both closure techniques and suture types appeared to be suitable for laparoscopic closure of the urinary bladder in adult horses.