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(a) The anvil was covered with the PGA sheet. (b) This anvil was set into the oral side of colon. (c) The PGA sheet was on the oral side of the colon with the anvil. (d) The schema of anastomosis. (e) The schema of staple and PGA sheet in this approach. One PGA sheet was used on the oral side. (f) The schema of staple and PGA sheet to be used in the future. Two PGA sheets were used on the oral and the anal side.for the PGA group versus 5.78 kPa for the nonPGA group, which did not differ statistically (p = 0.39) (Figure 4).Approach B: Clinical Short-Term OutcomesAll four pigs were alive and had no event of clin-ical findings, such as fever, infection of incisional wound, or appetite loss, after undergoing laparo-scopic AL with DST anastomosis. Although little postoperative adhesion was expected around the anastomosis during the second-look surgery, no anastomotic complications were evident in the abdominal cavity, such as bleeding, stricture forma-tion, or leakage (Table 1).Approach B: Histological Findings (Table 1)There was no histological leakage in the anasto-mosis. Histological findings showed increased fibro-blasts and neutrophils in both the PGA and the control groups. Slightly more granulation formation was noted around the anastomosis in the PGA 476cases than in the control case. Also, in the PGA group, the PGA sheet was observed to have remained in the anastomosis. These two groups showed no other significant differences except that of the remaining the PGA sheet fibers (Figure 5). In addition, abscess formation was found around the anastomosis in one of the PGA cases. However, there was some distance between the abscess formation and PGA sheet. Moreover, no necrotic tissue was observed near the anastomosis.Recently, several studies have reported the effec-tiveness of staple line reinforcing material for the prevention of anastomosis complications. This study assessed the usefulness and safety of a newly avail-able PGA sheet by two approaches in animal models to show the potential of this new PGA sheet for the DST anastomosis of the colorectal surgery. Approach A was aimed to assess its utility for the reinforcement of the circular anastomosis. Approach Figure 3　Colorectal anastomosis in the PGA group (Approach B)Discussion