Evaluation of a Vessel Sealing System, Bipolar Electrosurgery, Harmonic Scalpel, Titanium Clips, Endoscopic Gastrointestinal Anastomosis Vascular Staples and Sutures for Arterial and Venous Ligation in a Porcine Model

No AccessJournal of UrologyINVESTIGATIVE UROLOGY1 Feb 2003Evaluation of a Vessel Sealing System, Bipolar Electrosurgery, Harmonic Scalpel, Titanium Clips, Endoscopic Gastrointestinal Anastomosis Vascular Staples and Sutures for Arterial and Venous Ligation in a Porcine Model JAIME LANDMAN, KURT KERBL, JAMIL REHMAN, CASSIO ANDREONI, PETER A. HUMPHREY, WILLIAM COLLYER, EPHREM OLWENY, CHANDRU SUNDARAM, and RALPH V. CLAYMAN JAIME LANDMANJAIME LANDMAN More articles by this author , KURT KERBLKURT KERBL More articles by this author , JAMIL REHMANJAMIL REHMAN More articles by this author , CASSIO ANDREONICASSIO ANDREONI More articles by this author , PETER A. HUMPHREYPETER A. HUMPHREY More articles by this author , WILLIAM COLLYERWILLIAM COLLYER More articles by this author , EPHREM OLWENYEPHREM OLWENY More articles by this author , CHANDRU SUNDARAMCHANDRU SUNDARAM Financial interest and/or other relationship with Computer Motion. More articles by this author , and RALPH V. CLAYMANRALPH V. CLAYMAN Financial interest and/or other relationship with Applied Urology, Cook Urological, Microvasive, Orthopedic Systems, Inc. and Yamanouchi. More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(05)63995-XAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We assessed the usefulness of the LigaSure (Valleylab, Boulder, Colorado) vessel sealing system for vascular control during laparoscopic surgery and compared it with other available hemostatic modalities. Materials and Methods: A total of 31 domestic pigs were divided into 5 groups. In groups 1 and 2 the vessel sealing system was compared with titanium clips and Endo-GIA (United States Surgical, Stamford, Connecticut) staples. In group 3 the vessel sealing system was compared with standard Klepinger (Karl Storz, Culver City, California) bipolar forceps. In group 4 the harmonic scalpel and Trimax (United States Surgical) bipolar forceps were compared. In group 5 in vivo laparoscopic application of the vessel sealing system was evaluated. Results: The 5 mm. laparoscopic vessel sealing system sealed arteries up to 6 mm. and veins up to 12 mm. in diameter at supraphysiological bursting pressure. We evaluated 13 arteries with a diameter of 6 mm. or less at a mean bursting pressure of 662 mm. Hg (range 363 to 1,985) and 11 veins with a diameter of 12 mm. or less with a mean bursting pressure of 233 mm. Hg (range 63 to 440). Collateral tissue damage extended 1 to 3 mm. from the application site. Standard bipolar energy with Klepinger and Trimax forceps was less reliable and in some cases vessel sealing could not be accurately assessed before vessel division. Collateral tissue injury was 1 to 6 mm. The harmonic scalpel did not reliably seal vessels larger than 3 mm. but resulted in the least acute collateral tissue injury of 0 to 1 mm. Conclusions: In the porcine model the LigaSure system is a viable option for laparoscopic management of arteries up to 6 mm. and veins up to 12 mm. in diameter. References 1 : Ligation of the renal pedicle during laparoscopic nephrectomy: a comparison of staples, clips, and sutures. J Laparoendosc Surg1993; 3: 9. Google Scholar 2 : High-burst-strength, feedback-controlled bipolar vessel sealing. Surg Endosc1998; 12: 876. Google Scholar 3 Chandler J.G.: Mechanical and energy-based vessel ligation: a comparative study. Presented at Annual Congress of European Association for Endoscopic Surgery, Istanbul, Turkey, June 1997 Google Scholar From the Departments of Surgery (Division of Urology), Pathology and Immunology, Washington University School of Medicine, St. Louis, Missouri, Federal University, Division of Urology, Sao Paulo, Brazil, and Department of Urology, University of California-Irvine, Orange, California© 2003 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited byPhillips J, Narula N, Deane L, Box G, Lee H, Ornstein D, McDougall E and Clayman R (2018) Histological Evaluation of Cold Versus Hot Cutting: Clinical Impact on Margin Status for Laparoscopic Partial NephrectomyJournal of Urology, VOL. 180, NO. 6, (2348-2352), Online publication date: 1-Dec-2008. Volume 169Issue 2February 2003Page: 697-700 Advertisement Copyright & Permissions© 2003 by American Urological Association, Inc.Keywordssurgical equipmentswinehemostasisblood vesselslaparoscopyMetricsAuthor Information JAIME LANDMAN More articles by this author KURT KERBL More articles by this author JAMIL REHMAN More articles by this author CASSIO ANDREONI More articles by this author PETER A. HUMPHREY More articles by this author WILLIAM COLLYER More articles by this author EPHREM OLWENY More articles by this author CHANDRU SUNDARAM Financial interest and/or other relationship with Computer Motion. More articles by this author RALPH V. CLAYMAN Financial interest and/or other relationship with Applied Urology, Cook Urological, Microvasive, Orthopedic Systems, Inc. and Yamanouchi. More articles by this author Expand All Advertisement PDF downloadLoading ...