title: The Feasibility of LigaSure to Create Intestinal Anastomosis: Results of Ex Vivo Study.
abstract: OBJECTIVE
  To evaluate the feasibility and the effectiveness of LigaSure Forced Triad to create intestinal anastomosis in an ex vivo porcino model.
  
  
  METHODS
  Colon samples (n = 100) were prospectively randomized into 2 groups: LigaSure group (n = 90) and Stapler group (n = 10). The LigaSure group was divided into 9 subgroups, each of 10 samples, according to the different power levels of the LigaSure system (Bar 1, Bars 2, and Bars 3) and radiofrequency application (1 application, 2 applications, and 3 applications) used. All anastomoses were tested for early burst pressure. The LigaSure subgroup having the highest burst pressure was compared with the Stapler group. Finally, the specimen was reviewed by the same pathologist.
  
  
  RESULTS
  The burst pressures of the 9 subgroups of LigaSure segments were the following: 29.7 ± 4.5 (Subgroup a); 27.4 ± 3.1 (Subgroup b); 25.3 ± 4 (Subgroup c); 32.9 ± 2.3 (Subgroup d); 30.7 ± 3.8 (Subgroup e); 25.7 ± 4.8 (Subgroup f); 42 ± 4.7 (Subgroup g); 31.8 ± 3.8 (Subgroup h); and 28.5 ± 3 (Subgroup j). Subgroup g (3 bars-power levels/1 frequency application) had the highest burst pressure (P < .001; ANOVA test). No significant difference was found between burst pressure of Subgroup g and Stapler group (42 ± 4.7 vs 42 ± 4.3, respectively, P = .9). On histological view, the LigaSure anastomosis was formed by collagen sealed without cavitation defects.
  
  
  CONCLUSIONS
  Our study seems to confirm the feasibility of creating intestinal anastomosis using LigaSure. However, further researches in in vivo models are mandatory before recommending its clinical usage in such settings.
authors.affiliation: Thoracic Surgery Unit, Second University of Naples, Naples, Italy mario.santini@unina2.it.
authors.forename: Mario
authors.initials: M
authors.lastname: Santini
authors.affiliation: Thoracic Surgery Unit, Second University of Naples, Naples, Italy.
authors.forename: Alfonso
authors.initials: A
authors.lastname: Fiorelli
authors.affiliation: Thoracic Surgery Unit, Second University of Naples, Naples, Italy.
authors.forename: Gaetana
authors.initials: G
authors.lastname: Messina
authors.affiliation: Thoracic Surgery Unit, Second University of Naples, Naples, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Mazzella
authors.affiliation: Department of Morphopathology, Second University of Naples, Naples, Italy.
authors.forename: Marina
authors.initials: M
authors.lastname: Accardo
mesh_terms: D000714:Anastomosis, Surgical / Q000295:instrumentation* / Q000379:methods*; D000818:Animals; D001696:Biomechanical Phenomena; D005240:Feasibility Studies; D007422:Intestines / Q000502:physiology* / Q000601:surgery*; D011312:Pressure; D011446:Prospective Studies; D011897:Random Allocation; D013552:Swine
keywords: LigaSure; anastomosis; bipolar vessel sealing system; colon