Tissue fusion technology versus suture and staple in porcine bowel anastomosis: an in vivo study

The aim of this study was to make a comparison between the tissue fusion technique and conventional methods for sealing bowel anastomosis. Eighteen female domestic pigs (Suidae, Sus) were used in our study. Tissue-fused anastomoses (LigaSure groups) were made in 13 animals (5 anastomoses per animal), which were subdivided into 4 groups according to different manufacturing settings: “LigaSure-L-1” and “LigaSure-L-2”, with low energy output level with 1 or 2 device-activated tissue sealing times, and “LigaSure-M” and “LigaSure-H”, with medium or high energy output level. As controls, automatically stapled (GIA group) and hand-sewn (suture group) anastomoses were utilized in 3 and 2 animals, respectively. There was no statistical difference in the overall leakage rate between the GIA group (6.7%) and the LigaSure groups (15%) (P=1.000). There was less proliferating epithelium covering the anastomosis gap in the LigaSure groups compared with the other two groups. The gap between the two extremities of muscular layers of the anastomosis in the LigaSure groups was filled with collagen fibers. More proliferating cell nuclear antigen (PCNA)-positive cells were found in the anastomoses of the LigaSure groups compared with the other two groups (P=0.010). Our results showed that the tissue fusion technology was a feasible and safe method for anastomoses.