Sealing of vessels larger than 7 millimeters using enseal in porcine aorta

Abstract

Background: The Enseal (Ethicon Endo-Surgery, Blue Ash, Ohio) tissue-sealing device has proven efficacy for ligation of vessels <7 mm in diameter, even with significant supraphysiologic bursting pressures. We aimed to evaluate the safety of Enseal in porcine vessels >7 mm. Materials and Methods: The lumbar aortas of pigs that were euthanized for unrelated procedures were harvested. A 5- to 6-cm segment of aorta was sealed using the Enseal device. The opposite end was attached to a pressure- testing device to measure pressures at leak or bursting. The bivariate Pearson correlation was used to determine the relationship between diameter and bursting pressure. One-way analysis of variance was used to determine differences between the groups of vessels on the basis of their diameter. Results: Ninety samples of 5-cm aorta segments were used to assess bursting pressure. The median diameter was 14 mm (range, 7–18) and bursting pressure was 85 mm Hg (range, 24–650). The Pearson test showed a negative correlation between vessel diameter and bursting pressure (P =.25). One-way analysis of variance did not show any significant difference between vessel diameters grouped by size (P =.517), and neither did the Scheffe post hoc test when comparing diameter with bursting pressure; 31% of specimens failed to seal. Conclusions: Bursting pressures are low and inconsistent after tissue sealing with the Enseal device in porcine vessels >7 mm. These vessels also demonstrated a higher rate of failure to seal. The histologic results of the aorta segments (ie, a low collagen-elastin ratio) may be the cause of the low bursting pressures.