Gastrointestinal Staple Line Reinforcement

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Gastrointestinal resections and anastomoses are commonly performed using stapling devices in a wide range of open and laparoscopic procedures. Whether they are hand-sewn or stapled, anastomoses have an associated leak rate that can impart significant morbidity or mortality to a procedure. In addition, bleeding from staple lines can cause additional complications. Staple line reinforcement is one intervention that has been postulated to reduce both the leak rate and associated bleeding risk. This can be accomplished with either material applied exogenously to the staple line, as in an engineered absorbable biomaterial, or it may use a material - either absorbable or nonabsorbable - that is incorporated into the staple line. A number of reinforcements are currently available but all add time and cost to the procedures in which they are used. However, preventing the complications associated with leak and hemorrhage from staple lines may justify the added cost of these devices. A review of the available published literature was performed to review the current data pertaining to the reinforcement of living tissue and anastomoses with these various reinforcements available to surgeons.

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