Document Detail


An evaluation of electrosurgical vessel-sealing devices in biliary tract surgery in a porcine model.
MedLine Citation:
PMID:  21083796     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: The purpose of this study was to evaluate two electrosurgical vessel-sealing devices in biliary surgery.
METHODS: Porcine common bile ducts (CBDs) were sealed with two electrosurgical devices, an electrothermal bipolar vessel-sealing device (EBVS) and ultrasonic coagulation shears. Acute study animals underwent surgical bile duct sealing followed by immediate burst pressure testing. Chronic study animals were maintained for 1 week postoperatively and then tested.
RESULTS: The seal failure rate in the acute study was 50% for both the EBVS device and shears, and 0% for the laparoscopic surgical clip device used as a control. The latter had significantly higher burst pressures (646.2 ± 281.8 mmHg; P = 0.006) than the EBVS device (97.6 ± 86.6 mmHg) and shears (71.7 ± 89.3 mmHg). No significant difference in burst pressures was noted between the EBVS device and shears (97.6 ± 86.6 mmHg vs. 71.7 ± 89.3 mmHg). In the chronic study, obvious bile leaks occurred in one of four pigs (25%) in the EBVS device subgroup and two of four pigs (50%) in the shears subgroup. The average proximal CBD pressure in seven pigs was 16.1 ± 4.1 mmHg. The average chronic burst pressure in the control subgroup was 1088.0 ± 922.6 mmHg.
CONCLUSIONS: Given the high rates of failure of the EBVS device and the shears in consistently sealing biliary ducts, we do not recommend their routine use in biliary surgery.
Authors:
William W Hope; Srikanth Padma; William L Newcomb; Thomas M Schmelzer; Jessica J Heath; Amy E Lincourt; B Todd Heniford; H James Norton; John B Martinie; David A Iannitti
Related Documents :
18572366 - On the mechanism of action of pneumatic compression devices: combined magnetic resonanc...
18352196 - Role of pressure gradient on intrinsic toroidal rotation in tokamak plasmas.
18044656 - Instrumentation for epidural anesthesia.
18346016 - A comparison of hemolysis and red cell mechanical fragility in blood collected with dif...
8889406 - Assessment of coercive and noncoercive pressures to enter drug abuse treatment.
14634556 - The ability of traditional vital signs and shock index to identify ruptured ectopic pre...
Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  HPB : the official journal of the International Hepato Pancreato Biliary Association     Volume:  12     ISSN:  1477-2574     ISO Abbreviation:  HPB (Oxford)     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2010-11-18     Completed Date:  2011-03-25     Revised Date:  2011-12-21    
Medline Journal Info:
Nlm Unique ID:  100900921     Medline TA:  HPB (Oxford)     Country:  England    
Other Details:
Languages:  eng     Pagination:  703-8     Citation Subset:  IM    
Affiliation:
Division of Gastrointestinal and Minimally Invasive Surgery, Carolinas Medical Center, Charlotte, NC, USA. william.hope@seahec.net
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Animals
Biliary Tract Surgical Procedures / instrumentation*
Blood Loss, Surgical / prevention & control*
Common Bile Duct / surgery*
Electrosurgery / instrumentation*
Equipment Design
Equipment Failure
Equipment Failure Analysis
Female
Hemostasis, Surgical / instrumentation*
Laparoscopy / instrumentation*
Materials Testing
Models, Animal
Postoperative Hemorrhage / prevention & control*
Pressure
Stress, Mechanical
Surgical Equipment*
Swine
Time Factors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  A simple scoring system based on clinical factors related to pancreatic texture predicts postoperati...
Next Document:  Novel 3-D laparoscopic magnetic ultrasound image guidance for lesion targeting.