Sealing devices show distinct advantages in study

Shanghai, China-Seal strength tests on two laparoscopic instruments indicate that each offers separate advantages when sealing ureters and blood vessels, researchers reported at the World Congress of Endourology & SWL.

Clinically, the study findings serve as a guideline for surgeons who routinely use the two devices-the Harmonic ACE (Ethicon Endo-Surgery, Cincinnati) and the Ligasure V (Valleylab, Boulder, CO)-as adjuncts to standard monopolar electrosurgical instruments during the course of a laparoscopic procedure.

For the study, researchers from the University of California, Irvine, used a porcine model to seal multiple blood vessels and both ureters using each device. The burst pressure of the seals was tested, as were the seal time, seal quality, and the animals' serum albumin. The tissue was also submitted for histopathologic evaluation.

The Harmonic ACE appeared to cause a lower amount of subjective tissue damage than both one or two seals with the Ligasure V.

"In blood vessels, though some surgeons may seal the vessel twice when using the Ligasure V, this work suggests that one seal is better than a double seal.," said study co-author Michael Louie, MD, a clinical instructor in urology at the UC-Irvine, working with Ralph V. Clayman, MD, and colleagues.

As there appears to be more tissue effect when two seals are employed with the Ligasure V, one seal is the safer method, the researchers conclude. When considering the ureteral transection, both devices appear to be equally efficacious.