Okudaira Y, Yang Y, Kholoussy A M, Matsumoto T
Am Surg. 1984 Oct;50(10):564-8.
Inverted and everted staple lines, with and without division of the anterior gastric wall, were performed in 15 mongrel dogs to simulate reduction gastroplasty staple line. There were no significant differences in tensile strength and healing between staple lines at different postoperative periods. The tensile strength of the inverted staple line seemed to be stronger due to breakage of the adjacent gastric tissue. However, the tensile strength of the everted stapling without division of the gastric wall, which is used clinically, was almost equal to that of normal gastric tissue. In addition, there was satisfactory healing 4 weeks postoperatively in the everted stapling without dividing the gastric wall. These results suggest that the everted staple line without division of stomach is not inherently weaker to any significant extent than if the gastric wall was divided or inverted. The reported failure rate of this procedure may be due to other factors.