Sooriakumaran Prasanna, Kommu Sashi S, Cooke Joanne, Gordon Stephen, Brown Christian, Eddy Ben, Rimington Peter D, Rane Abhay
Department of Urology, Kingston Hospital, Surrey, UK.
BJU Int. 2009 May;103(10):1410-2. doi: 10.1111/j.1464-410X.2008.08211.x. Epub 2008 Nov 19.
To assess risk factors and predictors of failure of the Hem-o-lok(TM) vascular clip (Weck Closure Systems, Research Triangle Park, NC, USA) using vessels harvested from a porcine model.
Vessels of various diameters were harvested from a porcine model, clipped at 90 degrees or 45 degrees using the Hem-o-lok clip and then cut either flush or with a 1-mm cuff. The vessels were then connected to a burst-pressure device and pressures required to burst the clip or to cause it to leak were measured.
The Hem-o-lok clip leaked or burst when the vessel to which it was applied was cut flush. The clip became even more likely to fail if the angle of application of the clip was not at 90 degrees to the vessel surface.
The Hem-o-lok vascular clip is safe if it is applied at 90 degrees to the vessel surface and, more importantly, if a 1-mm cuff is left between the clip and the point at which the vessel is divided. We would therefore discourage the practice of not leaving this cuff of tissue, in an attempt to maximize vessel length during laparoscopic donor nephrectomy.
使用从猪模型获取的血管，评估Hem-o-lok™血管夹（美国北卡罗来纳州三角研究园的威克闭合系统公司）失败的风险因素和预测指标。
从猪模型获取不同直径的血管，使用Hem-o-lok夹以90度或45度进行夹闭，然后齐平切断或保留1毫米袖带后切断。接着将血管连接到爆破压力装置上，测量夹闭处破裂或渗漏所需的压力。
当应用Hem-o-lok夹的血管齐平切断时，该夹子会发生渗漏或破裂。如果夹子的应用角度与血管表面不是90度，夹子失败的可能性会更高。
如果Hem-o-lok血管夹以90度应用于血管表面，更重要的是，如果在夹子与血管切断点之间保留1毫米袖带，则该夹子是安全的。因此，我们不鼓励在腹腔镜供体肾切除术期间不保留此组织袖带以最大化血管长度的做法。
