Ex Vivo Biomechanical Comparison of 4 Suture Materials for Laparoscopic Bladder Closure in the Horse.
Authors: Ruzickova Pavlina, Burns Patrick, Piat Perrine, Frasch Martin G, Beauchamp Guy, Elce Yvonne A
Journal: Veterinary surgery : VS
Summary
Laparoscopic bladder repair offers horses minimally invasive surgery, but the optimal suture material and technique remain unclear. Using 42 cadaveric equine bladders, researchers compared four suturing approaches: 2-0 poliglecaprone with manual laparoscopic placement, 2-0 glycomer knotless barbed suture with manual placement, and 0 and 2-0 polyglyconate knotless barbed sutures deployed via automated laparoscopic device—all employing double-layer inverting closure patterns. Bursting strength pressures showed no significant differences amongst the repair techniques, though all sutured bladders performed substantially worse than intact controls (P<0.001), suggesting tissue trauma during repair is the limiting factor rather than material choice. Automated suturing devices dramatically reduced operative time compared to manual needle holder placement (P=0.001), which has clear implications for anaesthetic duration and surgical efficiency. Whilst knotless barbed sutures represent a practical alternative to conventional materials in laparoscopic bladder closure, the authors appropriately emphasise that dynamic biomechanical testing and clinical validation are essential before routine adoption in practice.
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Practical Takeaways
- •Knotless barbed suture is a viable option for laparoscopic bladder repair and may speed up surgical time with automated devices, but in vivo validation is still needed before routine clinical adoption.
- •Automated laparoscopic suturing systems are significantly faster than manual techniques, which could reduce anaesthesia time in clinical cases.
- •All repaired bladders showed reduced bursting strength compared to intact tissue, so careful post-operative management and follow-up are essential regardless of suture material chosen.
Key Findings
- •Bursting strength was significantly decreased in all repaired bladders compared to intact controls (P<0.001), with no significant differences between the 4 suture material groups.
- •Automated laparoscopic suturing devices (groups 3 and 4) were significantly faster than manual laparoscopic placement (groups 1 and 2; P=0.001).
- •Knotless barbed suture materials demonstrated comparable biomechanical performance to standard suture for laparoscopic bladder closure in this ex vivo model.