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Shingo KAWANO, Yutaka KOJIMA, Yuki TSUCHIYA, Shunsuke MOTEGI, Atsushi OKUZAWA, Kazuhiro SAKAMOTORyoichi TSUKAMOTO, Kazumasa KURE, Kiichi SUGIMOTO, Makoto TAKAHASHI, Objectives: Anastomotic complications after colorectal surgery are one of the most serious outcomes. To address this issue, this study used the newly developed bioabsorbable polyglycolic acid (PGA) sheet to assess its usefulness and safety using two approaches of double stapling technique (DST) after laparoscopic anterior resection (AR) in pig models.Methods: Rectal intratissue pressure was assessed after DST anastomosis in two groups, i.e., with (PGA group) or without PGA sheet (nonPGA group), which was sandwiched between the anastomosis in the first approach. In the second approach, after laparoscopic DST anastomosis with PGA sheet attached at anvil side, the clinical short-term outcomes within 1 week and histological findings at 1 week after the surgery were evaluated.Results: Assessment of rectal intratissue pressure showed a mean pressure of 9.28 kPa in the PGA group versus 5.78 kPa in the nonPGA group (p = 0.39). The results of clinical short-term outcomes revealed that there were no anastomotic complications. The results of histological findings in anastomotic bowel tissues with PGA sheet were not significantly different from those of the control case.Conclusions: The bioabsorbable PGA sheet can be used for colorectal DST anastomosis in animal models and may be a valuable tool for this procedure.Key words: colorectal anastomosis, bioabsorbable polyglycolic acid sheet, animal model, laparoscopic anterior resection, double stapling techniqueJuntendo Medical Journal2022. 68(5), 473-480Original ArticlesIntroductionAnastomotic complications after colorectal surgery are the main cause of postoperative morbidity, mortality, impaired quality of life, and prolonged hospital stay, in addition to creating the risk for permanent stoma. Anastomosis complications gener-ally include leakage, bleeding, and stenosis1, 2). Anas-tomotic leakage (AL) is one of the major complica-tions of colorectal surgery, especially in patients with rectal cancer. The occurrence of AL varies Department of Coloproctological Surgery, Juntendo University Factually of Medicine, Tokyo, JapanCorresponding author: Shingo Kawano (ORCID: 0000-0001-8547-1140)Department of Coloproctological Surgery, Juntendo University Factually of Medicine2-1-1, Hongo, Bunkyo-ku, Tokyo, 113-8421, JapanTEL: +81-3-3813-3111　E-mail: shingo@juntendo.ac.jp〔Received　Jan. 7, 2022〕〔Accepted　Jun. 6, 2022〕J-STAGE Advance published date: Aug. 15, 2022Copyright © 2022 The Juntendo Medical Society. This is an open access article distributed under the terms of Creative Commons Attribution License (CC BY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original source is properly credited. doi: 10.14789/jmj.JMJ22-0001-OAwidely from 3% to 30% and increases the postoper-ative mortality rate3-9). An option that holds promise to control leakage is that of staple line reinforce-ment, although use of this reinforcement in general is not new, previously described for bariatric surgery10, 11), pancreatic surgery12), and colorectal surgery13), 14).Several previous studies have assessed bioab-sorbable felt constituted from polyglycolic acid (PGA)/trimethylene carbonate. Franklin et al reported the first series of cases using staple line 473Application of the Bioabsorbable Polyglycolic Acid Sheet in Colorectal Anastomosis in Animal Models