Determination of cell viability after laparoscopic tissue stapling in a porcine model

Ramakrishna Venkatesh, Jamil Rehman, Jaime Landman, David Lee, Maged E. Ragab, Chandru Sundaram, Peter A. Humphrey, Ralph V. Clayman

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

Background and Purpose: Surgical stapling devices are often used to secure the distal ureter along with a cuff of bladder during laparoscopic nephroureterectomy. As the viability of cells within the stapled tissue would be important in patients with upper urinary-tract transitional-cell carcinoma, we determined the viability of cells within the lines of various commercially available staplers in a porcine model. Materials and Methods: Four laparoscopic stapling devices were used: two vascular and two tissue designs (US Surgical, Norwalk, CT, and Ethicon, Cincinnati, OH). The devices were deployed across a portion of the bladder, much as they would be during a nephroureterectomy to create a bladder cuff while excising the distal ureter. The animals were sacrificed 6 weeks later, and the stapled sites were harvested for histopathologic examination by an experienced genitourinary pathologist (PH). Results: Grossly, there were no visible staples at harvest of the stapled bladder and the ureterovesical junction, with a completely healed bladder being seen in all four animals. On histologic examination with hematoxylin and eosin staining, there were distinctly viable cells within the staple lines of the ureterovesical junction and the bladder wall, similar to the unstapled control tissue. There were viable cells in all samples of tissues stapled by either vascular or tissue staplers. Conclusions: Deployment of both vascular and tissue staplers resulted in viable cells within the staple lines at the ureterovesical junction and bladder wall in this porcine model. There is a potential risk of tumor recurrence at the stapled site in patients who have the ureter and bladder cuff secured with these devices during laparoscopic nephroureterectomy for upper-tract transitional-cell carcinoma. Despite this concern, to date, over a period of 13 years, clinical experience has not revealed a single case of tumor recurrence within the stapled cuff of bladder. Careful endoscopic evaluation of the stapled bladder-cuff site after laparoscopic nephroureterectomy should minimize the potential for local tumor recurrence.

Original languageEnglish
Pages (from-to)744-747
Number of pages4
JournalJournal of Endourology
Volume19
Issue number6
DOIs
StatePublished - Jul 2005

Fingerprint

Cell Survival
Urinary Bladder
Swine
Ureter
Blood Vessels
Equipment and Supplies
Transitional Cell Carcinoma
Recurrence
Surgical Stapling
Neoplasms
Hematoxylin
Eosine Yellowish-(YS)
Urinary Tract
Staining and Labeling
Cell Line

ASJC Scopus subject areas

  • Urology

Cite this

Venkatesh, R., Rehman, J., Landman, J., Lee, D., Ragab, M. E., Sundaram, C., ... Clayman, R. V. (2005). Determination of cell viability after laparoscopic tissue stapling in a porcine model. Journal of Endourology, 19(6), 744-747. https://doi.org/10.1089/end.2005.19.744

Determination of cell viability after laparoscopic tissue stapling in a porcine model. / Venkatesh, Ramakrishna; Rehman, Jamil; Landman, Jaime; Lee, David; Ragab, Maged E.; Sundaram, Chandru; Humphrey, Peter A.; Clayman, Ralph V.

In: Journal of Endourology, Vol. 19, No. 6, 07.2005, p. 744-747.

Research output: Contribution to journalArticle

Venkatesh, R, Rehman, J, Landman, J, Lee, D, Ragab, ME, Sundaram, C, Humphrey, PA & Clayman, RV 2005, 'Determination of cell viability after laparoscopic tissue stapling in a porcine model', Journal of Endourology, vol. 19, no. 6, pp. 744-747. https://doi.org/10.1089/end.2005.19.744
Venkatesh, Ramakrishna ; Rehman, Jamil ; Landman, Jaime ; Lee, David ; Ragab, Maged E. ; Sundaram, Chandru ; Humphrey, Peter A. ; Clayman, Ralph V. / Determination of cell viability after laparoscopic tissue stapling in a porcine model. In: Journal of Endourology. 2005 ; Vol. 19, No. 6. pp. 744-747.
@article{be48bcc8cc5644e3b69161c32d2d343f,
title = "Determination of cell viability after laparoscopic tissue stapling in a porcine model",
abstract = "Background and Purpose: Surgical stapling devices are often used to secure the distal ureter along with a cuff of bladder during laparoscopic nephroureterectomy. As the viability of cells within the stapled tissue would be important in patients with upper urinary-tract transitional-cell carcinoma, we determined the viability of cells within the lines of various commercially available staplers in a porcine model. Materials and Methods: Four laparoscopic stapling devices were used: two vascular and two tissue designs (US Surgical, Norwalk, CT, and Ethicon, Cincinnati, OH). The devices were deployed across a portion of the bladder, much as they would be during a nephroureterectomy to create a bladder cuff while excising the distal ureter. The animals were sacrificed 6 weeks later, and the stapled sites were harvested for histopathologic examination by an experienced genitourinary pathologist (PH). Results: Grossly, there were no visible staples at harvest of the stapled bladder and the ureterovesical junction, with a completely healed bladder being seen in all four animals. On histologic examination with hematoxylin and eosin staining, there were distinctly viable cells within the staple lines of the ureterovesical junction and the bladder wall, similar to the unstapled control tissue. There were viable cells in all samples of tissues stapled by either vascular or tissue staplers. Conclusions: Deployment of both vascular and tissue staplers resulted in viable cells within the staple lines at the ureterovesical junction and bladder wall in this porcine model. There is a potential risk of tumor recurrence at the stapled site in patients who have the ureter and bladder cuff secured with these devices during laparoscopic nephroureterectomy for upper-tract transitional-cell carcinoma. Despite this concern, to date, over a period of 13 years, clinical experience has not revealed a single case of tumor recurrence within the stapled cuff of bladder. Careful endoscopic evaluation of the stapled bladder-cuff site after laparoscopic nephroureterectomy should minimize the potential for local tumor recurrence.",
author = "Ramakrishna Venkatesh and Jamil Rehman and Jaime Landman and David Lee and Ragab, {Maged E.} and Chandru Sundaram and Humphrey, {Peter A.} and Clayman, {Ralph V.}",
year = "2005",
month = "7",
doi = "10.1089/end.2005.19.744",
language = "English",
volume = "19",
pages = "744--747",
journal = "Journal of Endourology",
issn = "0892-7790",
publisher = "Mary Ann Liebert Inc.",
number = "6",

}

TY - JOUR

T1 - Determination of cell viability after laparoscopic tissue stapling in a porcine model

AU - Venkatesh, Ramakrishna

AU - Rehman, Jamil

AU - Landman, Jaime

AU - Lee, David

AU - Ragab, Maged E.

AU - Sundaram, Chandru

AU - Humphrey, Peter A.

AU - Clayman, Ralph V.

PY - 2005/7

Y1 - 2005/7

N2 - Background and Purpose: Surgical stapling devices are often used to secure the distal ureter along with a cuff of bladder during laparoscopic nephroureterectomy. As the viability of cells within the stapled tissue would be important in patients with upper urinary-tract transitional-cell carcinoma, we determined the viability of cells within the lines of various commercially available staplers in a porcine model. Materials and Methods: Four laparoscopic stapling devices were used: two vascular and two tissue designs (US Surgical, Norwalk, CT, and Ethicon, Cincinnati, OH). The devices were deployed across a portion of the bladder, much as they would be during a nephroureterectomy to create a bladder cuff while excising the distal ureter. The animals were sacrificed 6 weeks later, and the stapled sites were harvested for histopathologic examination by an experienced genitourinary pathologist (PH). Results: Grossly, there were no visible staples at harvest of the stapled bladder and the ureterovesical junction, with a completely healed bladder being seen in all four animals. On histologic examination with hematoxylin and eosin staining, there were distinctly viable cells within the staple lines of the ureterovesical junction and the bladder wall, similar to the unstapled control tissue. There were viable cells in all samples of tissues stapled by either vascular or tissue staplers. Conclusions: Deployment of both vascular and tissue staplers resulted in viable cells within the staple lines at the ureterovesical junction and bladder wall in this porcine model. There is a potential risk of tumor recurrence at the stapled site in patients who have the ureter and bladder cuff secured with these devices during laparoscopic nephroureterectomy for upper-tract transitional-cell carcinoma. Despite this concern, to date, over a period of 13 years, clinical experience has not revealed a single case of tumor recurrence within the stapled cuff of bladder. Careful endoscopic evaluation of the stapled bladder-cuff site after laparoscopic nephroureterectomy should minimize the potential for local tumor recurrence.

AB - Background and Purpose: Surgical stapling devices are often used to secure the distal ureter along with a cuff of bladder during laparoscopic nephroureterectomy. As the viability of cells within the stapled tissue would be important in patients with upper urinary-tract transitional-cell carcinoma, we determined the viability of cells within the lines of various commercially available staplers in a porcine model. Materials and Methods: Four laparoscopic stapling devices were used: two vascular and two tissue designs (US Surgical, Norwalk, CT, and Ethicon, Cincinnati, OH). The devices were deployed across a portion of the bladder, much as they would be during a nephroureterectomy to create a bladder cuff while excising the distal ureter. The animals were sacrificed 6 weeks later, and the stapled sites were harvested for histopathologic examination by an experienced genitourinary pathologist (PH). Results: Grossly, there were no visible staples at harvest of the stapled bladder and the ureterovesical junction, with a completely healed bladder being seen in all four animals. On histologic examination with hematoxylin and eosin staining, there were distinctly viable cells within the staple lines of the ureterovesical junction and the bladder wall, similar to the unstapled control tissue. There were viable cells in all samples of tissues stapled by either vascular or tissue staplers. Conclusions: Deployment of both vascular and tissue staplers resulted in viable cells within the staple lines at the ureterovesical junction and bladder wall in this porcine model. There is a potential risk of tumor recurrence at the stapled site in patients who have the ureter and bladder cuff secured with these devices during laparoscopic nephroureterectomy for upper-tract transitional-cell carcinoma. Despite this concern, to date, over a period of 13 years, clinical experience has not revealed a single case of tumor recurrence within the stapled cuff of bladder. Careful endoscopic evaluation of the stapled bladder-cuff site after laparoscopic nephroureterectomy should minimize the potential for local tumor recurrence.

UR - http://www.scopus.com/inward/record.url?scp=23744450694&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=23744450694&partnerID=8YFLogxK

U2 - 10.1089/end.2005.19.744

DO - 10.1089/end.2005.19.744

M3 - Article

C2 - 16053369

AN - SCOPUS:23744450694

VL - 19

SP - 744

EP - 747

JO - Journal of Endourology

JF - Journal of Endourology

SN - 0892-7790

IS - 6

ER -