腹腔镜夹抵制血管内高压能力的实验研究

Experimental study of lapaxoscopic clips to withstand high intraluminal pressure

目的:探讨管腔内高压能否引起钛夹或可吸收夹松弛、移位或滑落,单个腹腔镜夹闭合管腔是否安全。方法:将犬的四肢及腹部不同管径的血管游离出体外,采用钛夹和可吸收夹夹闭血管,使管腔内压力逐渐升到40.0kPa,观察(1)钛夹和可吸收夹有无松弛、移位或滑落;(2)血管壁有无破裂;(3)管腔内是否达到预期压力40.0kPa。结果:当管腔内压力达到40.0kPa时,无血管壁破裂,无腹腔镜夹发生松弛、移位或滑落,钛夹、可吸收夹闭合血管能抵制40.0kPa高压。结论:钛夹或可吸收夹闭合管腔安全可靠,腹腔镜夹的松弛、移位或滑落与管腔内高压无关,单夹夹闭血管与双重或三重腹腔镜夹夹闭血管无明显差别。

Objective: To determine if clips for laparoscopic surgery become displaced with high intraluminal pressure and if a single laparoscopic clip applied correctly to a vessel is secure. Method: In an anesthetized living dog, segments of the artery and vein separate from the four limb's, abdominal, and cervical vessels were occluded by a single titanium or absorbable clip at either end of the vessel. The intraluminal pressure of the occluded segment was increased until ①the clip was loosened, ②the vessel burst, or ③the predetermined pressure (40.0kPa) was obtained. Results: No clip was displaced and loosened from any canine vessel at an intraluminal pressure of up to 40.0kPa. In none of the cases did the vessel burst when the predetermined pressure was obtained. The blood vessels could withstand high intraluminal pressure. Conclusion: Titanium and resorbable clips are safe and effective in providing haemostasis and securing tubular structures. Dislocation and looseness of clips have nothing to do with high intraluminal pressure. There is no difference between a single clip and dual clips or triple clips in withstanding high intraluminal pressure.