Electrosurgical vessel sealing has been demonstrated to have benefits for both patients and practitioners, but significant variation in the strength of the seal continues to be a concern. This study aims to examine the variation in electrosurgical seal quality along the length of a porcine common carotid artery and explore the relationships between seal quality, vessel size and morphology. Additionally, the study aimed to investigate the minimum safety threshold for successful seals and the influence of vessel characteristics on meeting this requirement. A total of 35 porcine carotid arteries were sealed using the PlasmaKinetic Open Seal device (Gyrus). Each seal was burst pressure tested and a sample taken for staining with elastin van Gieson’s stain, with morphological quantification using image processing software ImageJ. With increasing distance from the bifurcation, there was an increase in seal strength and a reduction in both elastin content and vessel outer diameter. A significant correlation was found between burst pressure with both outer diameter (p < 0.0001) and elastin content (p = 0.001). When considering the safe limits of operation, vessels of less than 5 mm in outer diameter were shown to consistently produce a seal of a sufficient strength (burst pressure > 360 mmHg) irrespective of vessel morphology.

Electrosurgical vessel sealing is used throughout many surgical procedures with the benefits of the device widely reported. However, there is still significant variation in the quality of the resulting seal with limited understanding as to why. This study developed a methodology to use digital image correlation to capture the sealing process and to investigate the changes occurring throughout. Porcine carotid arteries were used throughout the study, with seals created using the Gyrus G400 generator and the PKS Open Seal device (Gyrus Medical Ltd, Cardiff, United Kingdom).The displacement across the surface of the blood vessel and the device jaws was measured, and the true maximum principal strain was computed. There was significant contraction of the tissue along the length of the blood vessel, with this occurring in pulses due to the waveform used to deliver the current. Additionally, there was a significant change in displacement between the device jaws (0.08 mm), a novel finding of the study. This change in displacement is indicative of a change in application force throughout sealing, which can have significant implications in the quality of the seal, and therefore the findings of this study can influence future device design.