A Comparison of Laparoscopic Bipolar Vessel Sealing Devices in the Hemostasis of Small-, Medium-, and Large-Sized Arteries

Carbonell, Alfredo M.; Joels, Charles S.; Kercher, Kent W.; Matthews, Brent D.; Sing, Ronald F.; Heniford, B. Todd

doi:10.1089/109264203322656441

Cited by 124 publications

(103 citation statements)

References 4 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This device applies a precise amount of mechanical pressure and radiofrequency energy to tissue, causing fusion of apposing layers by creating a seal of denatured collagen and elastin fibers. This seal can than be transected, permitting the safe division of a multitude of tissues, including blood vessels with a diameter of up to 7 mm [2]. Since its introduction, the LigaSure device has indeed been proven beneficial in laparoscopic surgery, but at present it is used almost exclusively to divide tissues, especially the mesentery [6,8,17,18].…”

mentioning

confidence: 99%

Exploring new technologies to facilitate laparoscopic surgery: creating intestinal anastomoses without sutures or staples, using a radio-frequency-energy-driven bipolar fusion device

Smulders

Hingh

Stavast³

et al. 2007

Surg Endosc

View full text Add to dashboard Cite

Introduction: Intestinal anastomotic healing requires apposition of the collagencontaining submucosal layers of the opposing intestinal walls, which is traditionallyachieved by staples or sutures. Recently, a feedbackcontrolled bipolar sealingsystem (LigaSure) has been successfully introduced to seal and transect vessels.Since this technology depends on fusion of collagen fibres which are abundantlypresent in the intestinal wall, the possibility to create intestinal anastomoses usingthis technology was investigated in the present study. Materials and methods: For this purpose a newgeneration radiofrequency(RF) generator and a prototype of the Ligasure Anastomotic Device (LAD) have beendeveloped. The generator incorporates a closed loop control system which monitorstissue fusion, compares it with a mathematical model of ideal fusion based on thedensity and compliance of intestinal tissue and adjusts energy output accordingly. Intotal 8 anastomoses were created in a porcine model (4 pigs, 2 anastomoses each)and healing was assessed by macroscopic and histological examination. Results: All seals were macroscopic intact both immediate after creation and atsacrifice at the 7th postoperative day. Between operations, pigs appeared healthy andhad normal intestinal passage. Histological examination of the anastomoses revealedundisturbed healing with granulation tissue, newly synthesised collagen in thesubmucosa and re-epithelialization at the borders of the seals. Conclusion: These results confirm the feasibility to create experimental intestinalanastomoses using LigaSure technology. This may be an important step towards thedevelopment of new laparoscopic equipment combining dissecting and reconstructiveproperties within one single instrument.

show abstract

mentioning

confidence: 99%

Exploring new technologies to facilitate laparoscopic surgery: creating intestinal anastomoses without sutures or staples, using a radio-frequency-energy-driven bipolar fusion device

Smulders

Hingh

Stavast³

et al. 2007

Surg Endosc

View full text Add to dashboard Cite

show abstract

“…Thermal spread appears to be reduced when compared to traditional bipolar electrosurgical systems. Valleylab, Gyrus ACMI, and SurgRx, Inc. are three companies which have developed devices for both open and laparoscopic applications [48], [49], [50]. Smoke evacuation scavenger system can improve the operation field from smoggy atmosphere.…”

Section: Intra-operative Phasementioning

confidence: 99%

Electro-Surgery Practices and Complications in Laparoscopy

Wu¹

2011

Advanced Gynecologic Endoscopy

View full text Add to dashboard Cite

“…1). We chose the LigaSure scalpel, which has been employed in laparoscopic surgery and provides adequate tissue dissection while achieving efficient and safe hemostasis, sealing vessels up to 7 mm in size [3]. This bipolar electrosurgical device delivers high-current, low-voltage electrical energy along with pressure that is exerted from the jaws of the device onto the tissue.…”

mentioning

confidence: 99%

“…This bipolar electrosurgical device delivers high-current, low-voltage electrical energy along with pressure that is exerted from the jaws of the device onto the tissue. The system monitors the energy expended while denaturing the collagen and elastin within the vessel walls [3]. A transparent overtube usually used for injection sclerotherapy of esophageal varices (Kawano overtube, 16 mm diameter) was modified and used as a "duckbeak diverticuloscope."…”

mentioning

confidence: 99%