Micro-CT imaging as a method for comparing perfusion in graduated-height and single-height surgical staple lines

Matthew Eschbach,1 Gregory M Sindberg,2 Marisha L Godek,1 Matthew Nagelschmidt,1 Nicholas Paquette,3 Michael Wegener,1 James Alberino,1 Jane Mayotte,1 Amit Vasanji,4 Andrew M Miesse1 1Minimally Invasive Therapies Group, Medtronic, North Haven, CT, USA; 2Minimally Invasive Therapies Group, M...

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Auteurs principaux:	Eschbach M, Sindberg GM, Godek ML, Nagelschmidt M, Paquette N, Wegener M, Alberino J, Mayotte J, Vasanji A, Miesse AM
Format:	article
Langue:	EN
Publié:	Dove Medical Press 2018
Sujets:	Micro-CT perfusion surgical staplers graduated-height staples wound healing Medical technology R855-855.5
Accès en ligne:	https://doaj.org/article/c47b24505f124f33a074af3e4dfbdeee
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spelling	oai:doaj.org-article:c47b24505f124f33a074af3e4dfbdeee2021-12-02T04:08:48ZMicro-CT imaging as a method for comparing perfusion in graduated-height and single-height surgical staple lines1179-1470https://doaj.org/article/c47b24505f124f33a074af3e4dfbdeee2018-08-01T00:00:00Zhttps://www.dovepress.com/micro-ct-imaging-as-a-method-for-comparing-perfusion-in-graduated-heig-peer-reviewed-article-MDERhttps://doaj.org/toc/1179-1470Matthew Eschbach,1 Gregory M Sindberg,2 Marisha L Godek,1 Matthew Nagelschmidt,1 Nicholas Paquette,3 Michael Wegener,1 James Alberino,1 Jane Mayotte,1 Amit Vasanji,4 Andrew M Miesse1 1Minimally Invasive Therapies Group, Medtronic, North Haven, CT, USA; 2Minimally Invasive Therapies Group, Medtronic, Plymouth, MN, USA; 3Minimally Invasive Therapies Group, Medtronic, Mansfield, MA, USA; 4Image IQ, Cleveland, OH, USA Background: Wound healing is a goal for advanced technology in the surgical space to benefit clinical outcomes. Surgical staplers are commonly used in a variety of open and minimally invasive abdominal and thoracic procedures. Assessment of wound healing traits, such as perfusion, has been challenging due to technical limitations. A novel technique that utilizes micro-computed tomography methodology to measure perfusion was designed to compare the micro-perfusion of staple lines between commercial stapler reloads that employ different staple height strategies. Materials and methods: Following an Institutional Animal Care and Use Committee-approved protocol, rats were euthanized and immediately heparinized prior to a subtotal gastrectomy with either graduated-height or single-height staples. Rats were then perfused with barium, following which stomachs were removed and immediately fixed in formalin to prevent degradation. Stomachs were then imaged using micro-computed tomography and subsequent analysis was utilized to quantify fluid volume and patent vasculature proximity to staples within the staple line region for each group. Results: Average perfusion volume was significantly higher with graduated-height staples (0.33% ± 0.18%) compared to single-height staples (0.16% ± 0.09%, P=0.011). Average vessel-to-staple line distance was not significant but trended lower with graduated-height staples (0.35±0.02 mm) compared to single-height staples (0.36±0.03 mm, P=0.18). Discussion: Graduated-height staples had significantly higher perfusion volume than single-height staples, which likely has a downstream benefit on wound healing and clinical outcomes. Conclusion: This study shows a higher perfusion volume around the staple lines using graduated-height staples as compared to single-height staples and this may contribute to better wound healing in patients. Keywords: micro-computed tomography, wound healing, Tri-Staple, image processing, laparoscopic surgery, microvasculatureEschbach MSindberg GMGodek MLNagelschmidt MPaquette NWegener MAlberino JMayotte JVasanji AMiesse AMDove Medical PressarticleMicro-CTperfusionsurgical staplersgraduated-height stapleswound healingMedical technologyR855-855.5ENMedical Devices: Evidence and Research, Vol Volume 11, Pp 267-273 (2018)
institution	DOAJ
collection	DOAJ
language	EN
topic	Micro-CT perfusion surgical staplers graduated-height staples wound healing Medical technology R855-855.5
spellingShingle	Micro-CT perfusion surgical staplers graduated-height staples wound healing Medical technology R855-855.5 Eschbach M Sindberg GM Godek ML Nagelschmidt M Paquette N Wegener M Alberino J Mayotte J Vasanji A Miesse AM Micro-CT imaging as a method for comparing perfusion in graduated-height and single-height surgical staple lines
description	Matthew Eschbach,1 Gregory M Sindberg,2 Marisha L Godek,1 Matthew Nagelschmidt,1 Nicholas Paquette,3 Michael Wegener,1 James Alberino,1 Jane Mayotte,1 Amit Vasanji,4 Andrew M Miesse1 1Minimally Invasive Therapies Group, Medtronic, North Haven, CT, USA; 2Minimally Invasive Therapies Group, Medtronic, Plymouth, MN, USA; 3Minimally Invasive Therapies Group, Medtronic, Mansfield, MA, USA; 4Image IQ, Cleveland, OH, USA Background: Wound healing is a goal for advanced technology in the surgical space to benefit clinical outcomes. Surgical staplers are commonly used in a variety of open and minimally invasive abdominal and thoracic procedures. Assessment of wound healing traits, such as perfusion, has been challenging due to technical limitations. A novel technique that utilizes micro-computed tomography methodology to measure perfusion was designed to compare the micro-perfusion of staple lines between commercial stapler reloads that employ different staple height strategies. Materials and methods: Following an Institutional Animal Care and Use Committee-approved protocol, rats were euthanized and immediately heparinized prior to a subtotal gastrectomy with either graduated-height or single-height staples. Rats were then perfused with barium, following which stomachs were removed and immediately fixed in formalin to prevent degradation. Stomachs were then imaged using micro-computed tomography and subsequent analysis was utilized to quantify fluid volume and patent vasculature proximity to staples within the staple line region for each group. Results: Average perfusion volume was significantly higher with graduated-height staples (0.33% ± 0.18%) compared to single-height staples (0.16% ± 0.09%, P=0.011). Average vessel-to-staple line distance was not significant but trended lower with graduated-height staples (0.35±0.02 mm) compared to single-height staples (0.36±0.03 mm, P=0.18). Discussion: Graduated-height staples had significantly higher perfusion volume than single-height staples, which likely has a downstream benefit on wound healing and clinical outcomes. Conclusion: This study shows a higher perfusion volume around the staple lines using graduated-height staples as compared to single-height staples and this may contribute to better wound healing in patients. Keywords: micro-computed tomography, wound healing, Tri-Staple, image processing, laparoscopic surgery, microvasculature
format	article
author	Eschbach M Sindberg GM Godek ML Nagelschmidt M Paquette N Wegener M Alberino J Mayotte J Vasanji A Miesse AM
author_facet	Eschbach M Sindberg GM Godek ML Nagelschmidt M Paquette N Wegener M Alberino J Mayotte J Vasanji A Miesse AM
author_sort	Eschbach M
title	Micro-CT imaging as a method for comparing perfusion in graduated-height and single-height surgical staple lines
title_short	Micro-CT imaging as a method for comparing perfusion in graduated-height and single-height surgical staple lines
title_full	Micro-CT imaging as a method for comparing perfusion in graduated-height and single-height surgical staple lines
title_fullStr	Micro-CT imaging as a method for comparing perfusion in graduated-height and single-height surgical staple lines
title_full_unstemmed	Micro-CT imaging as a method for comparing perfusion in graduated-height and single-height surgical staple lines
title_sort	micro-ct imaging as a method for comparing perfusion in graduated-height and single-height surgical staple lines
publisher	Dove Medical Press
publishDate	2018
url	https://doaj.org/article/c47b24505f124f33a074af3e4dfbdeee
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Micro-CT imaging as a method for comparing perfusion in graduated-height and single-height surgical staple lines

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