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, Cássio; Humphrey, Peter A.; Collyer, William C.; Olweny, Ephrem O.; Sundaram, Chandru P.; Clayman, Ralph V.

doi:10.1016/s0022-5347(05)63995-x

Cited by 245 publications

(123 citation statements)

References 2 publications

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“…An experimental study on porcine demonstrated that the harmonic scalpel should not be used to seal vessels larger than 3 mm [22]. In the same study, the harmonic scalpel was shown to cause less peripheral tissue damage than electrocautery.…”

Section: Discussionmentioning

confidence: 98%

Use of the harmonic scalpel versus conventional haemostatic techniques in patients with Grave disease undergoing total thyroidectomy: a prospective randomised controlled trial

Hallgrimsson

Lovén

Westerdahl

et al. 2008

Langenbecks Arch Surg

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Section: Discussionmentioning

confidence: 98%

Use of the harmonic scalpel versus conventional haemostatic techniques in patients with Grave disease undergoing total thyroidectomy: a prospective randomised controlled trial

Hallgrimsson

Lovén

Westerdahl

et al. 2008

Langenbecks Arch Surg

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“…2 The device delivers a controlled high-power current at a low voltage to melt and fuse the collagen and elastin within the vessel walls. These seals can withstand a minimum of 3 times the normal systolic pressure, resulting in a distinctive permanent translucent seal zone.…”

mentioning

confidence: 99%

“…In a study that compared the LigaSure system to ultrasonic coagulation, bipolar coagulation, surgical clips, and sutures, the LigaSure system created seals stronger than those created by other energy-based ligation methods and comparable in strength with those created by mechanical ligation techniques. 2 Notably, this vessel sealing mechanism produces significantly reduced thermal spread compared with bipolar instruments, as energy is automatically switched off when tissue impedance reaches a critical level. 2 Furthermore, the current delivered to achieve hemostasis takes between 2 and 7 seconds, which is faster than suture ligation.…”

mentioning

confidence: 99%

Experience and Efficacy of a Bipolar Vessel Sealing System for Radical Abdominal Hysterectomy

Kyo

Mizumoto

Hashimoto

et al. 2009

Int J Gynecol Cancer

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The present study evaluated the efficacy of an electrosurgical bipolar vessel sealing system for radical abdominal hysterectomy (RAH). A total of 85 consecutive patients who underwent RAH with pelvic lymphadenectomy for cervical cancer or endometrial cancer were analyzed; in 18 patients, the LigaSure system (Valleylab, Boulder, Colo) was used to secure the vascular pedicles, and in the remaining 67 patients, clamps were used, and the pedicles suture ligated. Compared with the conventional suture group, the patients in the LigaSure group had a significantly shorter operation time (mean, LigaSure 242.8 +/- 36.1 minutes vs conventional, 349.1 +/- 82.6) minutes; P < 0.001) and lower blood loss (mean, 583.1 +/- 287.6 mL vs 999.0 +/- 524.2 mL; P < 0.005). Only 1 (0.06%) of the 18 patients in the LigaSure group was transfused, whereas 27 (40.2%) of the 67 patients in the conventional suture group were transfused. Because transfusion requirements may be affected by the surgeon's bias, we compared blood loss among untransfused patients and found that the LigaSure group still had significantly lower blood loss than the conventional suture group (mean, 550.9 +/- 233.1 mL vs 745.49.0 +/- 230.4 mL; P < 0.01). Hemoglobin level reduction after surgery in untransfused patients was significantly lower in the LigaSure group than in the conventional suture group (mean, 2.31 +/- 2.22 mg/dL vs 3.22 +/- 1.11 mg/dL; P < 0.05). These findings indicate that the LigaSure vessel sealing system is useful to reduce blood loss and shorten operating time at RAH.

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“…The electrothermal bipolar vessel sealing system is approved for clinical occlusion of arteries (d 6 mm) and veins (d 12 mm) [58]. It uses mechanical compression combined with electrical heating to cause collagen bridging between vessel walls [59].…”

Section: Effect Of Heating On Vessels and Highintensity Focused Ultramentioning

confidence: 99%

Pathophysiological mechanisms of high-intensity focused ultrasound-mediated vascular occlusion and relevance to non-invasive fetal surgery

Shaw

Haar

Rivens

et al. 2014

J. R. Soc. Interface.

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ReviewCite this article: Shaw CJ, ter Haar GR, Rivens IH, Giussani DA, Lees CC. 2014 Pathophysiological mechanisms of high-intensity focused ultrasound-mediated vascular occlusion and relevance to non-invasive fetal surgery. J. R. Soc. High-intensity focused ultrasound (HIFU) is a non-invasive technology, which can be used occlude blood vessels in the body. Both the theory underlying and practical process of blood vessel occlusion are still under development and relatively sparse in vivo experimental and therapeutic data exist. HIFU would however provide an alternative to surgery, particularly in circumstances where serious complications inherent to surgery outweigh the potential benefits. Accordingly, the HIFU technique would be of particular utility for fetal and placental interventions, where open or endoscopic surgery is fraught with difficulty and likelihood of complications including premature delivery. This assumes that HIFU could be shown to safely and effectively occlude blood vessels in utero. To understand these mechanisms more fully, we present a review of relevant cross-specialty literature on the topic of vascular HIFU and suggest an integrative mechanism taking into account clinical, physical and engineering considerations through which HIFU may produce vascular occlusion. This model may aid in the design of HIFU protocols to further develop this area, and might be adapted to provide a non-invasive therapy for conditions in fetal medicine where vascular occlusion is beneficial.

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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.

Cited by 245 publications

References 2 publications

Use of the harmonic scalpel versus conventional haemostatic techniques in patients with Grave disease undergoing total thyroidectomy: a prospective randomised controlled trial

Use of the harmonic scalpel versus conventional haemostatic techniques in patients with Grave disease undergoing total thyroidectomy: a prospective randomised controlled trial

Experience and Efficacy of a Bipolar Vessel Sealing System for Radical Abdominal Hysterectomy

Pathophysiological mechanisms of high-intensity focused ultrasound-mediated vascular occlusion and relevance to non-invasive fetal surgery

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