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

Abstract

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.

Differences in Thyroidectomy Outcomes Based on Surgical Method: A Comparison of LigaSure Precise, Harmonic Focus, and Traditional Methods

“…LigaSure can be used to close vessels up to 7 mm in diameter, with a range of 2 to 3 mm for thermal injury; the Harmonic scalpel can close vessels up to 5 mm in diameter, with a safety measure of 2 mm for thermal injury. 11,12 Although these devices offer shorter overall operating times compared with the traditional suture and ligation approach, 13 they have not been shown to improve complication rates.…”

Perioperative outcomes using LigaSure™ compared to conventional bipolar instruments in laparoscopic salpingo-oophorectomy: a randomized controlled trial

“…In vitro studies comparing feedback-controlled bipolar cutting devices to conventional bipolar electrosurgery, harmonic scalpel, clips, and staples in porcine vessels proved that a feedback-controlled bipolar cutting device was inferior to clip and staple technology and required more time to effect vessel occlusion. However, in regard to other electrosurgical modalities, a feedback-controlled bipolar cutting device was superior to standard bipolar energy [3].…”

“…Most of these laparoscopic studies involved bowel surgery and compared LigaSure with ultrasonic devices [8,16,19,20]. The reduction in blood loss with the LigaSure in those studies may be explained by the less effective hemostasis in large vessels by ultrasonic devices [25][26][27]. One other study that compared LigaSure with conventional bipolar instruments in a random way in laparoscopic hysterectomy was also not able to detect any significant differences with respect to operating time or blood loss [28].…”

“…This method of vessel sealing relies on the application of a precise amount of bipolar electrocoagulation and pressure to the tissue, leading to the denaturation of the collagen and elastin in vessel walls, resulting in a hemostatic seal [2]. The technique is able to seal vessels of up to 7 mm in diameter and the seal can withstand a maximum of three times the normal systolic pressure [3]. In addition, compared with conventional bipolar instruments, this vessel-sealing mechanism has a reduced thermal spread profile [3], potentially decreasing the risk of injury to adjacent structures.…”

“…The technique is able to seal vessels of up to 7 mm in diameter and the seal can withstand a maximum of three times the normal systolic pressure [3]. In addition, compared with conventional bipolar instruments, this vessel-sealing mechanism has a reduced thermal spread profile [3], potentially decreasing the risk of injury to adjacent structures.…”