Associate Professor Michigan State University Eaton Rapids, Michigan
Full-thickness intestinal biopsies are used in clinical diagnosis of equine intestinal disorders, and research evaluating gastrointestinal physiology. Laparoscopic biopsy techniques currently described are associated with risks of post-operative peritonitis and adhesion formation. We have designed a biopsy technique to address these complications, using a 4-S Roeder suture loop to close the bowel prior to biopsy followed by an inverting oversew with barbed suture to minimize mucosal exposure at the incision. The purpose of this study was to evaluate this oversewn suture loop (SL-BS) technique compared to a 2-layer hand-sewn (HS) biopsy in equine cadavers. Our hypotheses were that the SL-BS biopsies would 1) be similar in strength, 2) cause less deformation of the intraluminal diameter, and 3) provide a full-thickness sample comparable to HS biopsies. Intestine was obtained from eight healthy horses after euthanasia. Maximal bursting pressure (BP) using fluid distension was evaluated with a pressure catheter, contrast radiography was used to determine change in luminal diameter, and size of the biopsies was measured with a micrometer. All biopsies were full thickness, but SL-BS were smaller than HS (P<0.01). HS and SL-BS samples had lower BP than controls (P<0.01), but BP were similar between HS and SL-BS (P=0.10). Reduction in intraluminal diameter after biopsy was similar for both methods (P>0.16). The study is limited as it was performed in cadavers, but the outcomes support further investigation of the SL-BS method in vivo as a laparoscopic method to obtain full thickness biopsies.
