The application of the V-Loc closure device for gastrointestinal sutures: a preliminary study.

BACKGROUND: Leakage is one of the major complications in gastrointestinal surgery. This preliminary study compared a new barbed absorbable thread for gastrointestinal sutures with monofil suture material in a cadaver model. METHODS: In this study, mechanical experiments were performed in 20 recently deceased individuals. Incisions were made in the small intestine, colon, and stomach, and then sutures were created with the V-Loc closure device and monofil suture material. Intestinal bursting pressure was measured by inserting a balloon and slowly filling it with air until there was a dehiscence, or wall or suture rupture. RESULTS: The bursting pressures differed significantly between the two sutures in the small intestine, showing the advantage of the V-Loc closure device, which had a mean bursting pressure of 116.2 mmHg compared with 110 mmHg for the monofil suture (p = 0.003). The mean bursting pressure did not differ significantly between the two sutures in the colon and the stomach. The mean bursting pressures for the V-Loc closure device were 141.3 mmHg (stomach) and 137.2 mmHg (colon) compared with the monofil suture material bursting pressures of 133 mmHg (stomach) and 134.8 mmHg (colon). CONCLUSIONS: Because the bursting strength of the sutures created with monofil suture material differs significantly from that of the V-Loc closure device, the V-Loc suture material should be used for gastrointestinal sutures. Although the two sutures did not differ significantly in the colon or the stomach, the V-Loc closure device should be used for these as well because its advantages may overrule those of the monofil suture. No knot tying is required, and the operating time can be shorter. Especially for laparoscopic surgery, the V-Loc closure device is recommended.

V-Loc, a new wound closure device for peritoneal closure--is it safe? A comparative study of different peritoneal closure systems.

BACKGROUND: Transabdominal laparoscopic hernia repair is a safe and commonly used procedure for groin hernias. Failure of peritoneal closure is rare but can lead to herniation and bowel obstruction. A new wound closure device named V-Loc was tested in this study. It consists of a barbed absorbable thread that is self-anchoring and eliminates the need to tie a knot. The efficacy of this device in achieving secure peritoneal closure was investigated. METHODS: In 10 recently deceased patients, peritoneal incisions were set and closed with 5 different devices including V-Loc. Peritoneal thickness was measured prior to testing. A tensiometer was used to apply tensile loads on the peritoneal closure. Tensile loads were measured in Newton at the time of peritoneal rupture or failure of the suture or knot. RESULTS: Peritoneal thickness had a significant impact on the results (P < .0001). A mean tensile load of 7.41 N was tolerated when the peritoneal thickness was ≤0.25 mm and 15.38 N when the peritoneal thickness was >0.25 mm. Peritoneal rupture was observed more often than failure of closure. The latter occurred more often at high tension and in experiments with tacking or stapling devices than with sutures. While testing V-Loc, peritoneal rupture occurred at 19.85 N, mean, showing significantly better results than AbsorbaTack, extracorporally knotted running suture, or Multifire Endo Hernia Stapler (P < .05). CONCLUSIONS: The new wound closure device V-Loc is a feasible and promising alternative to common peritoneal closure techniques but is yet to be evaluated in clinical studies.