Comparison between two systems of electrosurgical bipolar vessel sealing for the hemostasis of medium-sized arteries

Abstract

Objective: To compare the mean burst-strength pressure and measure the collateral thermal spread between the new EBVS (HemoSaccab) and the commercial EBVS (ERBE VIO) systems. Materials and Methods: Sixty fresh common carotid arteries from swines were sealed with the HemoSaccab or the ERBE VIO systems. Before device applications, saline was perfused and held into the arterial lumen at the resting pressure of 129.25 mmHg. Then, the arterial segment was sealed with the BiClamp 150 instrument which attached to the HemoSaccab or the ERBE VIO generators. When the seal cycle finished, the seal was inspected visually for translucency. Then, saline was perfused toward the sealed end. Pressure was increased from 129.25 to 361.90 mmHg at a 77.55 mmHg increment. At each pressure increment, the pressure was maintained for 10 seconds before another increment of the pressure. Luminal pressure was recorded when saline leaks from the sealed end or pressure reached 361.90 mmHg. If leaking occurs during application of hemostasis or at 129.25 mmHg within 10 seconds, that seal is considered as sealing failure. An additional 40 arteries were sealed with two systems and sectioned for histological examination to measure the collateral thermal spread. Results: Mean burst-strength pressure of the HemoSaccab was statistically significant higher than the ERBE VIO systems (350.7 +- 33.7 and 270.6 +- 85.8 mmHg, respectively, p = 0.00). While the collateral thermal spread was not difference between the two systems (1.71 +- 0.36 and 1.76 +- 0.40mm, respectively, p = 0.63). Conclusion: The HemoSaccab system is as effective as the ERBE VIO system to seal the medium-sized vessel.