Patent Ductus Arteriosus Ligation: The LigaSure System May Be Unreliable

Influence of multiple reuse and resterilization cycles on the performance of a bipolar vessel sealing device (LigaSure) intended for single use

“…Although our study assessed LigaSure handsets designed for open procedures, many of the spectrum of LigaSure technology handsets are intended for minimally invasive procedures, in which regaining control of a hemorrhaging vessel can be more technically challenging. In support of our observation, there is a report in the medical literature describing the intraoperative consequences of a failed LigaSure vascular seal . However, the overwhelming burden of evidence suggests that use of the LigaSure handsets reduces intraoperative hemorrhage compared with traditional techniques .…”

“…In support of our observation, there is a report in the medical literature describing the intraoperative consequences of a failed LigaSure vascular seal. 27 However, the overwhelming burden of evidence suggests that use of the LigaSure handsets reduces intraoperative hemorrhage compared with traditional techniques. [28][29][30] Ultimately, it is the responsibility of each surgeon choosing to employ a reused handset to balance the increasing risk of vascular seal failure with multiple reuse cycles against the reduced cost of a beneficial technology.…”

Surgical treatment of a persistent right aortic arch with concurrent patent ductus arteriosus in a 4‐month‐old German shepherd dog

“…Although it is not uncommon for the LA to be ligated during surgical treatment of PRAA in isolation to minimize the risk of haemorrhage, the uses of vessel sealing devices are commonly employed when PRAA is treated with MIS techniques (Nucci et al., 2018 ; Townsend et al., 2016 ). In a recent human case report, the uses of vessel sealing devices for division of PDA have been questioned due to the decreased amount of collagen present in the PDA relative to other vessels and the resultant significant haemorrhage that had been encountered during its use (Zamfir et al., 2007 ). Considering these factors, when a PDA is identified simultaneously with a PRAA, surgical approaches should be carefully considered.…”

Video-assisted thoracoscopic patent ductus arteriosus closure in 2,000 patients

“…5,6 Subsequently, many surgeons started to use this technique and reported success rates of 88%-98% with laryngeal nerve dysfunction in 0.6%-3.4%, residual shunt in 0%-5.9%, and without the other potential limitations of alternative methods. 7,[9][10][11] Zamfir and colleagues 12 used the LigaSure Vessel Sealing System (LVSS) for PDA closure in a patient in 2007; although the perioperative result was satisfactory, it failed to keep the ductus closed for more than 1 day, and the patient was reoperated on due to a residual shunt revealed by echocardiography. The reoperation was performed in conditions of severe hemorrhage.…”