Vessel sealing comparison: old school is still hip

Area of Science:

• Surgical Technology
• Biomedical Engineering
• Vascular Surgery

Background:

• Traditional vessel ligation uses sutures, but new sealing technologies are emerging.
• Limited objective data exists comparing the efficacy of various vessel sealing methods.
• Surgical closure of vessels is critical for hemostasis.

Purpose of the Study:

• To objectively compare diverse surgical vessel sealing methods.
• To evaluate sealing strength using a standardized ex vivo pressure challenge.
• To provide data on the performance of mechanical and energy-based vessel sealing devices.

Main Methods:

• Ten common surgical sealing devices (mechanical and energy) were tested.
• Porcine carotid arteries were used in a reproducible ex vivo setup.
• Arteries were pressurized until sealing failure, with maximum pressure recorded.

Main Results:

• 184 trials assessed 10 different vessel sealing methods.
• Average burst pressure was 1100 mmHg, ranging from 51.3 to 5171 mmHg.
• Suture-based methods showed the highest burst pressures, while stapling methods showed the lowest.

Conclusions:

• Ex vivo testing revealed significant variations in sealing strength among methods.
• All tested hemostatic modalities safely secured vessels above physiologic pressures.
• Suture-based methods were significantly stronger than mechanical and energy devices.