Schuld Jochen, Sperling Jens, Kollmar Otto, Menger Michael D, Schilling Martin K, Richter Sven, Laschke Matthias W
Department of General, Visceral, Vascular, and Pediatric Surgery, University of Saarland, Homburg/Saar, Germany.
J Laparoendosc Adv Surg Tech A. 2011 Sep;21(7):659-63. doi: 10.1089/lap.2011.0191. Epub 2011 Jul 20.
Nightknife(©) is a novel reusable bipolar vessel sealing device. In the present study we analyzed its efficiency and quality of vessel sealing in comparison to a standard instrument (LigaSure™).
Mesenteric veins and arteries of 5 Swabian-Hall pigs were sealed by means of Nightknife and LigaSure. Thermal performance of both devices was assessed by dynamic thermography. Analysis of the sealed vessels included the determination of seal failure rates and heat-associated macroscopic tissue appearance.
The overall sealing rate of Nightknife was significantly higher than that of LigaSure (95.8% versus 87.0%; P=.012). This was associated with a more pronounced thermal spread (8.22±0.13 versus 7.12±0.10 mm; P=.012) and tissue desiccation (2.15±0.06 versus 1.86±0.07; P=.003). Moreover, sealing time (12.30±0.17 versus 7.72±0.17 seconds; P=.038) and tissue temperature (93.73°C±0.69°C versus 66.71°C±2.18°C; P=.001) were significantly higher with the use of Nightknife. Logistic regression analysis revealed that the degree of tissue desiccation correlated with the overall sealing success.
Nightknife is as appropriate as LigaSure for the successful sealing of mesenteric vessels despite significant differences in tissue alterations and sealing time between the two devices.
Nightknife（©）是一种新型可重复使用的双极血管封闭装置。在本研究中，我们将其与标准器械（LigaSure™）相比较，分析了其血管封闭的效率和质量。
使用Nightknife和LigaSure对5只施瓦本-哈尔猪的肠系膜静脉和动脉进行封闭。通过动态热成像评估两种装置的热性能。对封闭血管的分析包括确定封闭失败率和与热相关的宏观组织外观。
Nightknife的总体封闭率显著高于LigaSure（95.8%对87.0%；P = 0.012）。这与更明显的热扩散（8.22±0.13对7.12±0.10毫米；P = 0.012）和组织干燥有关（2.15±0.06对1.86±0.07；P = 0.003）。此外，使用Nightknife时，封闭时间（12.30±0.17对7.72±0.17秒；P = 0.038）和组织温度（93.73°C±0.69°C对66.71°C±2.18°C；P = 0.001）显著更高。逻辑回归分析显示，组织干燥程度与总体封闭成功率相关。
尽管两种装置在组织改变和封闭时间上存在显著差异，但Nightknife与LigaSure一样适合成功封闭肠系膜血管。
