Comparison of laparoscopic aortic clamps in a pulsatile circulation model

Area of Science:

• Vascular Surgery
• Biomedical Engineering
• Materials Science

Background:

• Laparoscopic surgery requires specialized instruments.
• Aortic clamps are critical for vascular procedures.
• Evaluating instrument performance under simulated physiological conditions is essential.

Purpose of the Study:

• To assess the fatigue characteristics, safety, and effectiveness of laparoscopic aortic clamps.
• To evaluate clamp performance in a pulsatile circulation model.

Main Methods:

• A pulsatile circulation model using bovine aortas was established with a heart-lung machine.
• Four laparoscopic aortic clamp models underwent 120-hour testing under simulated physiological conditions (82/min, 200/120 mm Hg).
• Clamps were opened and closed 40 times; failures and defects were recorded and analyzed via electron microscopy.

Main Results:

• Two clamp models were eliminated due to preliminary defects or ineffective aortic occlusion.
• Model B clamps showed mechanical defects early in testing; Model D clamps failed to occlude aortas.
• Model A clamps and one Model C clamp performed effectively without failure during the 120-hour test; however, two Model C clamps failed during application.

Conclusions:

• A high rate of clamping failures and mechanical deficits were observed.
• Only one of the four tested laparoscopic aortic clamp models (Model A) demonstrated adequate safety and effectiveness for clinical use.
• Enhanced collaboration between vascular surgeons and instrument manufacturers is crucial for developing reliable laparoscopic vascular clamps.