title: How securely is the testicular artery occluded in the spermatic cord by using a ligature?
abstract: BACKGROUND
  There are no studies on the ideal ligature technique for the spermatic cord.
  
  
  OBJECTIVE
  To compare the maximal resistance pressure in the testicular artery and the maximal tensile forces to produce failure of 2 different ligature techniques used for ligation of the equine spermatic cord.
  
  
  METHODS
  The capabilities of 2 types of ligatures, single knot loop and double knot loop, were assessed using a pressure-resistance test in testicular arteries and with an in vitro mechanical evaluation of the tensile strength by single cycle-to-failure testing.
  
  
  RESULTS
  In the pressure-resistance test, the mean ± s.d. peak force at failure of the single knot loop was 354.4 ± 91.7 mmHg and for the double knot loop 303.2 ± 62.0 mmHg. There was no significant difference between the maximal load to failure of the single knot loop and double knot loop technique. The pressure needed for rupture was significantly higher (P = 0.001) than for leakage. The maximal tensile force at failure of the single knot loop was significantly higher than the double knot loop (P = 0.028). There was no significant difference in load elongation properties to failure between the single knot loop and double knot loop.
  
  
  CONCLUSIONS
  Although no significant differences were obtained in the pressure-resistance test, the single knot loop sustained significantly greater load to failure than the double knot loop in single cycle-to-failure testing. Based on these findings, it would appear that the performance of the single knot loop should be superior to the double knot loop.
  
  
  CONCLUSIONS
  Both ligature techniques are able to withstand the normal physiological intravascular pressure. The single knot loop has the greater breaking strength of the 2 ligatures tested and is less time consuming to perform and may therefore have advantages during equine castration.
authors.affiliation: Veterinary Clinic Duurstede, Wijk bij Duurstede, The Netherlands. a.rijkenhuizen@gmail.com
authors.forename: A B M
authors.initials: AB
authors.lastname: Rijkenhuizen
authors.forename: S
authors.initials: S
authors.lastname: Sommerauer
authors.forename: M
authors.initials: M
authors.lastname: Fasching
authors.forename: K
authors.initials: K
authors.lastname: Velde
authors.forename: C
authors.initials: C
authors.lastname: Peham
mesh_terms: D000818:Animals; D006736:Horses / Q000033:anatomy & histology*; D008026:Ligation; D008297:Male; D009919:Orchiectomy / Q000379:methods / Q000662:veterinary*; D013085:Spermatic Cord / Q000601:surgery*; D013737:Testis / Q000098:blood supply*
keywords: castration; equine; horse; knot security; ligation technique