Hartmann colostomy with ligasure

Abstract

Abstract:Purpose: While LigaSure is commonly used for blood vessel closure, our aim was to research the effectiveness of using the latter tool for the purpose of closing intestines in rats. Methods: Twenty Wistar albino rats were divided into two groups per 10 each. In Group 1, the sigmoid colon was cut from its middle and its distal was closed with 4/0 silk. In Group 2, on the other hand, the sigmoid colon was divided from the middle with LigaSure LS1200 probe and its distal was closed with LigaSure. In both groups, the proximal sigmoid colon was entered by means of colostomy with 4/0 silk to the left part of the abdomen. Operation durations, adhesion levels and explosion pressures were recorded. Tissue samples were taken for tissue hydroxyproline level. Results: While the average duration of the operation was 25.7 minutes in Group 1, it was 18.8 minutes in Group 2 and the difference between them was signifi cant in favour of LigaSure. (p<0.001). Stump explosion pressure was 181.4 (160-190) mmHg in average in the suture group (Group 1), and 173.3 (150-190) mmHg in the LigaSure group (Group 2) and the difference between them was not statistically signifi cant. Tissue hydroxyproline level was 123.6 (13-232) in Group 1, in Group 2 and no signifi cant difference was determined between the groups. Adhesion level between the groups was also similar.Conclusions: This study experimentally shows that the duration of effective stump closure as part of Hartman colonostomy can be shortented with LigaSure (Tab. 1, Fig. 4, Ref. 12 LigaSure vessel closure technology is a system providing permanent blood vessel wall fusion by denaturing the collagen and elastin in the blood vessel wall and transforming it into a haemostatic plug (1). It allows fast closure of tissues without performing dissection. It has been shown in studies that vessels which are closed with LigaSure are not opened at a pressure up to three times the normal systolic blood pressure at minimum (2).It has been shown in the studies that closure with LigaSure is as effective as clipping and ligation. The closure process is permanent and continuous. In case of intestinal closure, it has been considered to use LigaSure as well because similarly as blood vessel wall the intestinal wall also contains a matrix of elastin and collagen. It was aimed to research the effectiveness of the use of LigaSure in intestine closure in rats as a step to clinical studies and new technological improvements. MethodsThe study was performed by taking the permit of the ethical committee under resolution No. 2011-47 at Selcuk University Experimental Medicine Research and Application Centre.Twenty Wistar albino rats of 250-350 gr of weight, 4-6 months of age were divided into two groups per 10 each. Food was administered ad libitum. The operation was carried out under general anaesthesia by giving intraperitoneal ketamine hydrochloride (80 mg/kg) and xylazin (10 mg/kg). The area was cleaned with povidon iodine after shaving the hair. In all rats, laparatomy was performed with an incisio...