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Evaluation of a commercial vascular clip: risk factors and predictors of failure from in vitro studies
Author(s) -
Sooriakumaran Prasanna,
Kommu Sashi S.,
Cooke Joanne,
Gordon Stephen,
Brown Christian,
Eddy Ben,
Rimington Peter D.,
Rane Abhay
Publication year - 2009
Publication title -
bju international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 1464-4096
DOI - 10.1111/j.1464-410x.2008.08211.x
Subject(s) - medicine , cuff , leak , nephrectomy , surgery , kidney , engineering , environmental engineering
OBJECTIVE 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. MATERIALS AND METHODS Vessels of various diameters were harvested from a porcine model, clipped at 90° or 45° 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. RESULTS 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° to the vessel surface. CONCLUSION The Hem‐o‐lok vascular clip is safe if it is applied at 90° 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.