Safety Evaluation of Surgical Staple Line Reinforcement in Glissonean Stapling: A Preliminary Study in Porcine Liver

Abstract

Introduction

Laparoscopic liver resection is an established surgical technique utilizing automatic staplers; however, the safety of extrahepatic Glissonean pedicle transection in this context remains unclear. This study evaluated the safety and pressure resistance of surgical staple line reinforcement in Glissonean stapling using a porcine liver model.

Methods

The Glissonean sheath was stapled with either Tri-Staple or staple line reinforcement, and artificial blood was infused into the hepatic artery. Pressures were gradually increased up to 1000 mmHg to assess leakage from the resection margin.

Results

No leakage was observed in staple line reinforcement-treated sheaths, even at pressures exceeding 1000 mmHg, whereas Tri-Staple-treated sheaths leaked at a median pressure of 428.5 mmHg.

Conclusions

These findings suggest that staple line reinforcement provides superior sealing performance, reducing intraoperative bleeding risks and eliminating the need for additional reinforcement. Further studies involving live models are necessary to confirm these results and establish clinical applicability.