Background: A variety of energy-based techniques for arterial and venous vessel ligation have recently been introduced. Using a porcine model we studied the efficacy of the novel reusable BiClamp
versus the standard disposable LigaSure bipolar vessel sealing device. We also compared whether
arteries respond differently than veins upon sealing.
Materials and Methods: In five Swabian Hall pigs, splenectomy and nephrectomy were performed using two different bipolar vessel sealing devices. Measurements of the sealed arteries and veins (diameter
2–7 mm) included rate of seal failure, burst strength, and heat-associated vascular wall morphologic
appearance. An additional three animals underwent splenectomy, salpingo-oophorectomy,
and small bowel resection, and vessel seals were studied histologically after a seven-day survival period
for vessel wall fusion, inflammation, and fibrous organization.
Results: Sealing was highly successful, with only one seal failure overall and thus no difference between the two instruments analyzed. The burst pressures of BiClamp-sealed arteries (842 ± 117
mm Hg) did not differ from that of arteries sealed with LigaSure (856 ± 102 mm Hg), but were significantly
higher than the burst pressures of veins (155 ± 26 and 216 ± 71 mm Hg, respectively)
(P < 0.05). Independent of the sealing device used, thermal spread was found increased in veins
compared to arteries. Histologic analysis after seven days revealed appropriate healing of the vessel
wall, including thrombus fibrosis, fibroblast proliferation, and collagen deposition. With both
devices, however, the venous but not the arterial walls still presented with massive inflammatory
cell infiltrates.
Conclusion: Our study indicates that the BiClamp device is as appropriate as the LigaSure instrument to successfully ligate 2–7 mm arteries and veins, demonstrating supraphysiological bursting
strengths and adequate lumenal fusion healing. However, veins are more prone to collateral tissue
damage and inflammatory wall infiltration.
