The use of bipolar cautery, laparosonic coagulating shears, and vascular clips for hemostasis of small and medium-sized vessels

H. Spivak, W. S. Richardson, John Hunter

Research output: Contribution to journalArticle

90 Citations (Scopus)

Abstract

Advanced laparoscopic surgery requires a reliable method of hemostasis. In order to determine the efficacy of common hemostatic devices, we tested bipolar electrosurgery (BPES), laparosonic coagulating shears (LCS), and vascular clips (VC) on arteries of various sizes to compare the strength of hemostasis against elevated intraarterial pressure. The procedures were performed on a porcine model through a laparotomy. Segments of visceral arteries were isolated and cannulated with an angiocatheter that was linked to a pressure monitor. After hemostasis with the tested instrument and division of the vessel, the intraarterial pressure was elevated by infusion of saline solution through the angiocatheter. The pressure was recorded when bleeding occurred through the cut end of the vessel or when the pressure reached 300 mm Hg. All three devices were effective in maintaining hemostasis on small (diameter, 0.25-0.5 mm) and medium-sized arteries (diameter, 2-3.5 mm) with a success rate ranging between 75% and 100% (p = n.s.). Practice and technical finesse were required with the use of the LCS and BPES before excellent results could be obtained. The LCS has an advantage over BPES because it allows the surgeon to perform hemostasis and division simultaneously, thus keeping the operating field clean and avoiding instrument adhesion to the tissue.

Original languageEnglish (US)
Pages (from-to)183-185
Number of pages3
JournalSurgical Endoscopy and Other Interventional Techniques
Volume12
Issue number2
StatePublished - Feb 1998
Externally publishedYes

Fingerprint

Cautery
Hemostasis
Surgical Instruments
Blood Vessels
Electrosurgery
Pressure
Arteries
Tissue Adhesions
Equipment and Supplies
Hemostatics
Sodium Chloride
Laparoscopy
Laparotomy
Swine
Hemorrhage

Keywords

  • Bipolar electrosurgery
  • Harmonic scalpel
  • Hemostasis
  • Vascular clips

ASJC Scopus subject areas

  • Surgery

Cite this

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