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

Jaime Landman, Kurt Kerbl, Jamil Rehman, Cassio Andreoni, Peter A. Humphrey, William Collyer, Ephrem Olweny, Chandru Sundaram, Ralph V. Clayman

Research output: Contribution to journalArticle

211 Citations (Scopus)

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.

Original languageEnglish (US)
Pages (from-to)697-700
Number of pages4
JournalJournal of Urology
Volume169
Issue number2
DOIs
StatePublished - Feb 1 2003
Externally publishedYes

Fingerprint

Electrosurgery
Titanium
Surgical Instruments
Sutures
Ligation
Blood Vessels
Swine
Veins
Arteries
Pressure
Sus scrofa
Wounds and Injuries
Hemostatics
Laparoscopy

Keywords

  • Blood vessels
  • Hemostasis
  • Laparoscopy
  • Surgical equipment
  • Swine

ASJC Scopus subject areas

  • Urology

Cite this

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. / Landman, Jaime; Kerbl, Kurt; Rehman, Jamil; Andreoni, Cassio; Humphrey, Peter A.; Collyer, William; Olweny, Ephrem; Sundaram, Chandru; Clayman, Ralph V.

In: Journal of Urology, Vol. 169, No. 2, 01.02.2003, p. 697-700.

Research output: Contribution to journalArticle

Landman, Jaime ; Kerbl, Kurt ; Rehman, Jamil ; Andreoni, Cassio ; Humphrey, Peter A. ; Collyer, William ; Olweny, Ephrem ; Sundaram, Chandru ; Clayman, Ralph V. / 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. In: Journal of Urology. 2003 ; Vol. 169, No. 2. pp. 697-700.
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AU - Landman, Jaime

AU - Kerbl, Kurt

AU - Rehman, Jamil

AU - Andreoni, Cassio

AU - Humphrey, Peter A.

AU - Collyer, William

AU - Olweny, Ephrem

AU - Sundaram, Chandru

AU - Clayman, Ralph V.

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AB - 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.

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