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Invited Critique
October 19, 2009

To Mesh or Not to Mesh, That Is the QuestionComment on “Use of Seamguard to Prevent Pancreatic Leak Following Distal Pancreatectomy”

Arch Surg. 2009;144(10):899. doi:10.1001/archsurg.2009.34

Yamamoto and colleagues are to be congratulated on the third and, thus far, the largest single-institution series examining the addition of a buttress to reinforce a stapled distal pancreatic transection. I, along with my colleagues, have also presented a case series on this subject,1 and, like my own, the article by Yamamoto et al has a number of significant shortcomings that prevent a definitive conclusion regarding the effectiveness of buttressing.

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