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How secure are laparoscopically placed clips? An in vitro and in vivo study
M T Nelson1, M Nakashima, S J Mulvihill
1Department of Surgery, University of California, San Francisco.
Archives of Surgery (Chicago, Ill. : 1960)
|June 1, 1992
Summary
The Ligaclip provides more secure laparoscopic hemostatic clip application than the Endo Clip. Surgeons should consider this when choosing clips to prevent accidental dislodgement during procedures.
Area of Science:
- Surgical Devices
- Minimally Invasive Surgery
- Vascular Surgery
Background:
- Hemostatic clips are crucial for controlling bleeding during laparoscopic surgery.
- Ensuring the security of these clips is vital to prevent complications.
- Different clip designs may offer varying levels of security.
Purpose of the Study:
- To compare the security of two laparoscopic hemostatic clips: Endo Clip and Ligaclip.
- To evaluate clip dislodgement forces in vitro and in vivo.
- To inform surgeons about clip security differences.
Main Methods:
- In vitro testing involved measuring transverse and axial dislodgement forces on silicone tubing.
- In vivo evaluation assessed clip security on mesenteric vessels in anesthetized pigs.
- Laparoscopic application was simulated for both clip types.
Main Results:
- In vitro, Ligaclip required greater force for transverse and axial dislodgement compared to Endo Clip.
- In vivo, Ligaclip showed significantly lower rates of movement or dislodgement (11%) versus Endo Clip (34%).
Conclusions:
- Ligaclip demonstrates superior security for laparoscopic hemostatic clip application compared to Endo Clip.
- Laparoscopic surgeons must be aware of the potential for clip dislodgement, particularly with the Endo Clip.
- Choosing more secure clips like Ligaclip can enhance patient safety in laparoscopic procedures.