Special topics on laparoscopic surgical equipment -- Ligating clips

Special topics on laparoscopic surgical equipment -- Ligating clips

  • Detailed introduction


Adequate hemostasis is essential during laparoscopic surgery to ensure a clear visual field of the surgical area. Primary prevention of bleeding by carefully dissecting and identifying vascular structures using a variety of laparoscopic devices is essential before the surgeon separates the vascular structures as needed. However, when bleeding does occur, these devices can be used to stop the bleeding safely and effectively so that laparoscopic surgery can continue.

◆◆ligating clips◆◆

As with open surgery, laparoscopic surgery uses a U-shaped hemostatic clip to prevent vascular bleeding during the incision. Before the vessel is cut, it needs to be carefully identified, separated, and then clamped with a hemostatic clip. In laparoscopic surgery, titanium clips are used instead of stainless steel clips, which are easier to operate because they do not become magnetized. There are various types of surgical clamp can be used with 5mm or 10mm disposable clamp; Reusable pliers are also available. However, the tendency of reusable pliers to shed the hemostatic clip and the additional time required to reassemble the instrument limits their usefulness in laparoscopic surgery.The standard U-shaped hemostatic clip may fall off due to arterial pulsing or operation of the surgical area during further separation. Multiple surgical clips (up to 5) may be used as required. Caution is recommended when using standard surgical clips to close vessels larger than 3mm in diameter.

 

The polymer ligation clamp system (e.g., HEM-O-Lok) contains a self-locking device to reduce slippage of the surgical clamp from the large vessel ; Blood vessels up to 16mm in diameter can be treated with these clips. It is necessary to separate the blood vessel from the surrounding tissue before placing the surgical clamp, as the hook-like locking device can easily penetrate adjacent tissue (e.g., veins). Slippage of the clamp may also occur, more likely when the clamp is not placed vertically at a 90 degree Angle to the vessel or when the vessel end is less than 1mm in length.

 

Locking clips are useful in procedures where the pedicle is securely clipped and the length of the vessel is preserved (e.g., donor nephrectomy, splenectomy, adrenectomy, pneumonectomy, and colectomy).


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