Can LigaSure seal and divide the small bowel?
BACKGROUND
The LigaSure system (Valleylab, Boulder, CO) seals vessels by reforming collagen and elastin in vessel walls. We studied the feasibility and effectiveness of LigaSure in dividing porcine small bowel.


METHODS
Twelve porcine small bowel portions were randomized to division with either endoscopic linear stapler or LigaSure system and the burst pressure of the sealed ends were measured.


RESULTS
Segments sealed with staples (6), LigaSure Atlas (Valleylab) (7), LigaSure Xtd (Valleylab) (4), and double-sealed with LigaSure Atlas (Valleylab) (4) were compared. Burst pressure for stapled segments was 131 (standard deviation [SD] 19) mm Hg; failure occurred in the bowel wall. Burst pressures for the 3 groups of Ligasure segments were 27 (SD 5), 20 (SD 6), and 11 (SD 13) mm Hg, respectively, with no statistically significant difference among them; failure occurred at the sealed end. Burst pressure for stapled segments was significantly higher than that of Ligasure segments (P < .001).


CONCLUSIONS
LigaSure does not safely seal small bowel.
Salameh
Jihad R
JR
Department of Surgery, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS 39216, USA. jsalameh@surgery.umsmed.edu
Schwartz
Jay H
JH
Hildebrandt
Drew A
DA
D000714:Anastomosis, Surgical / Q000295:instrumentation* / Q000662:veterinary; D000818:Animals; D004195:Disease Models, Animal; D015718:Fibrin Tissue Adhesive; D006488:Hemostasis, Surgical / Q000295:instrumentation; D007421:Intestine, Small / Q000601:surgery*; D011336:Probability; D011897:Random Allocation; D012680:Sensitivity and Specificity; D013525:Surgical Instruments; D013552:Swine; D013718:Tensile Strength
D015718:Fibrin Tissue Adhesive