A canine model for inferior vena cava resection was devised to study the biomechanical and clinical applications o f the cartridge stapler, which applies a triple staggered staple line. Eighteen mongrel dogs were subjected to subhepatic, suprarenal inferior vena cava occlusion with excision o f the excluded segment. A t I hour, six dogs were killed and inferior vena cava sizes and pressures were measured. All staple lines were intact. The inferior vena cava bursting pressure was 150 to 300 m m Hg. Ten dogs survived to 6 weeks and underwent repeat laparotomy with excision and measurement o f the remaining inferior vena cava. Mean diameter was 1.9 cm. N o evidence o f staple line leakage was found despite chronic pressures to 39 cm H 2 0 : median static bursting pressures were 250 m m Hg. Vein wall thickness o f >0.24 m m were all satisfactorily stapled. Histologic examination revealed normal reendothelialization, with improved healing at higher chronic pressures. N o evidence o f inflammation at the staple line or foreign body reaction was found. We conclude that a triple staple line provides secure, rapid venous occlusion that can withstand supraphysiologic stresses immediately and at 6 weeks.
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