Comparative Study of the Efficacy and Safety Between Two Bipolar Instruments (EnSeal® and Ligasure™) in Ex-Vivo Porcine Vessel Sealing

  • Agostinho Cordeiro Hospital de Braga https://orcid.org/0000-0002-5502-0223
  • Mariana Conde Escola Ciências da Saúde – Universidade do Minho, Braga, Portugal
  • João Torres Serviço de Urologia do Hospital de Braga, Braga, Portugal; Escola Ciências da Saúde – Universidade do Minho, Braga, Portugal
  • Nuno Morais Serviço de Urologia do Hospital de Braga, Braga, Portugal
  • Paulo Mota Serviço de Urologia do Hospital de Braga, Braga, Portugal; Escola Ciências da Saúde – Universidade do Minho, Braga, Portugal
  • Ana Rocha Centro Materno-Infantil do Norte – Department of Women and Reproductive Medicine, Porto, Portugal
  • Giovanni Grimaldi Universitá degli Studi di Napoli “Federico II” – Dipartimeno di Neuroscienze ed Scienze Riproduttive, Naples, Italy
  • Francisco Botelho Serviço de Urologia do Hospital de Braga, Braga, Portugal; Departamento de Epidemiologia - Faculdade de Medicina da Universidade do Porto, Porto, Portugal
  • Vitor H. Nogueira Serviço de Urologia do Hospital de Braga, Braga, Portugal
  • Estevão Lima Serviço de Urologia do Hospital de Braga, Braga, Portugal; Escola Ciências da Saúde – Universidade do Minho, Braga, Portugal
Keywords: Endovascular Procedures, Hemostasis, Surgical, Models, Animal, Swine, Vascular Surgical Procedures

Abstract

Introduction: Hemostasis is a central issue in laparoscopic surgery. There are no clear guidelines when it comes to the choice of what energy scissor to use. This study compares the efficiency and security between EnSeal® and LigasureTM in the sealing of arteries and veins in an ex-vivo porcine model.

Methods: The instruments were compared with each other with respect to cutting speed and burst pressure (BP) after vessel harvest. The coagulation and cut levels of the generators were set up at a constant level. A group of vessels was sent for histological evaluation with assessment of thermal damage and histological seal.

Results: A total of 124 vessels were tested. Overall, LigasureTM was the fastest instrument in all types of vessels and EnSeal® was the slowest. There were no statistically significant differences between the BP, except for the group of medium arteries, where the BP generated by LigasureTM were significantly higher than the ones generated by EnSeal®. In the same group of vessels LigasureTM was the one with the lowest percentage of seal failures. There was no association between the number of seal failures and the size of the vessel. There was, however, an association between the number of seal failures in arteries versus veins, with a larger number of failure in arteries for both instruments, compared to none failure in veins with LigasureTM. Although no statistically significant differences were found between the seals of the two instruments, the one with the highest median sealing length in both arteries and veins is LigasureTM, which theoretically may mean a more reliable sealing.

Conclusion: LigasureTM provides the fastest and most reliable seal, with superior BP in medium arteries comparatively to EnSeal®, and greater sealing length median, both in arteries and veins. However, it presented significantly higher thermal damage than EnSeal®.

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Author Biography

Agostinho Cordeiro, Hospital de Braga

Urology Resident Urologist

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Published
2018-07-24