| An evaluation of electrosurgical vessel-sealing devices in biliary tract surgery in a porcine model. | |
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MedLine Citation:
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PMID: 21083796 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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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 |
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Publication Detail:
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Type: Comparative Study; Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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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:
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Created Date: 2010-11-18 Completed Date: 2011-03-25 Revised Date: 2011-12-21 |
Medline Journal Info:
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Nlm Unique ID: 100900921 Medline TA: HPB (Oxford) Country: England |
Other Details:
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Languages: eng Pagination: 703-8 Citation Subset: IM |
Affiliation:
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Division of Gastrointestinal and Minimally Invasive Surgery, Carolinas Medical Center, Charlotte, NC, USA. william.hope@seahec.net |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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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
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