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Can LigaSure seal and divide the small bowel?
Jihad R Salameh1, Jay H Schwartz, Drew A Hildebrandt
1Department of Surgery, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS 39216, USA. jsalameh@surgery.umsmed.edu
Background:
The LigaSure system (Valleylab, Boulder, CO) seals vessels by reforming collagen and elastin in vessel walls. We studied the feasibility and effectiveness of LigaSure in dividing porcine small bowel.
Methods:
Twelve porcine small bowel portions were randomized to division with either endoscopic linear stapler or LigaSure system and the burst pressure of the sealed ends were measured.
Results:
Segments sealed with staples (6), LigaSure Atlas (Valleylab) (7), LigaSure Xtd (Valleylab) (4), and double-sealed with LigaSure Atlas (Valleylab) (4) were compared. Burst pressure for stapled segments was 131 (standard deviation [SD] 19) mm Hg; failure occurred in the bowel wall. Burst pressures for the 3 groups of Ligasure segments were 27 (SD 5), 20 (SD 6), and 11 (SD 13) mm Hg, respectively, with no statistically significant difference among them; failure occurred at the sealed end. Burst pressure for stapled segments was significantly higher than that of Ligasure segments (P < .001).
Conclusion:
LigaSure does not safely seal small bowel.
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