Assessment of the LapraTy clip for facilitating reconstructive laparoscopic surgery in a porcine model.

OBJECTIVES

To assess the efficacy, reliability, and performance of the LapraTy clip (LTc) as a substitute for knot tying during reconstructive surgery in a porcine model.

METHODS

Twenty-four farm pigs were divided in two groups, each undergoing two surgical procedures: group A, transperitoneal laparoscopic cavotomy and small-bowel enterotomy with repair, and group B, laparoscopic partial nephrectomy and cystotomy with repair. In all animals LTc were used to replace knot tying. Tissue specimens were harvested and examined at 2, 4, and 8 weeks postoperatively to assess success of reconstruction and tissue reaction.

RESULTS

There were no major complications. Animals in group A showed no clinical signs of caval obstruction. No intraperitoneal collections or significant narrowing were noted at the enterotomy sites. Animals in group B showed no evidence of fluid collections around the partially resected kidneys or the cystotomy sites, and all repairs were intact. Pathologic examination revealed that all LTc were encapsulated by fibroblasts and giant cells typical of a foreign body-type granulomatous reaction. No evidence of clip migration into the epithelium was noted in any of the tissues examined.

CONCLUSIONS

In an animal model, the LTc is a safe and efficient alternative to knot tying during laparoscopic reconstructive surgery. We are currently evaluating the clinical applicability of the LTc in a variety of urologic conditions. We believe that other surgical specialties should evaluate this device as well.