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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
American Journal of Surgery
|May 25, 2006
Summary
The LigaSure system is not effective for sealing porcine small bowel. Stapled segments demonstrated significantly higher burst pressure than LigaSure-sealed segments, indicating a risk of failure at the seal site.
Area of Science:
- Surgical Technology
- Gastrointestinal Surgery
- Biomaterials Science
Background:
- The LigaSure system utilizes heat to reform collagen and elastin for vessel sealing.
- Its application in dividing porcine small bowel was investigated.
Purpose of the Study:
- To evaluate the feasibility and effectiveness of the LigaSure system for dividing porcine small bowel.
- To compare the sealing integrity of LigaSure against endoscopic linear staplers.
Main Methods:
- Twelve porcine small bowel portions were randomized.
- Division was performed using either an endoscopic linear stapler or the LigaSure system.
- Burst pressure of the sealed ends was measured to assess sealing integrity.
Main Results:
- Stapled segments exhibited a mean burst pressure of 131 mm Hg (SD 19), with failure in the bowel wall.
- LigaSure-sealed segments showed significantly lower mean burst pressures (27 mm Hg [SD 5], 20 mm Hg [SD 6], and 11 mm Hg [SD 13]).
- Failure in LigaSure groups occurred at the sealed end, and burst pressure was significantly lower than stapled segments (P < .001).
Conclusions:
- The LigaSure system does not provide safe and effective sealing for porcine small bowel division.
- Endoscopic linear staplers offer superior sealing integrity compared to LigaSure for this application.