Veterinary surgery : VS · 2020
In vitro holding strength of the laparoscopic Miller's knot compared with open Miller's knot, open surgeon's throw, and laparoscopic surgeon's throw in a vascular pedicle model.
Сравнительное исследованиеСтатьяНазвание и аннотация: Перевод пока не подготовлен
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Erickson Andrea K, Fox-Alvarez W Alexander, Regier Penny J, Case J Brad
Аннотация
OBJECTIVE: To compare in vitro knot holding strength of the laparoscopic Miller's knot (LMK), open Miller's knot (MK), open surgeon's throw (Sx), and laparoscopic surgeon's throw (LSx) in a vascular pedicle model when used as the first throw for vascular ligation.
STUDY DESIGN: Experimental study.
SAMPLE POPULATION: Ten constructs each of the Miller's knot and surgeon's throw performed openly and laparoscopically with 2-0 polyglyconate suture.
METHODS: Knot holding strengths of the LMK, MK, LSx, and Sx knots were evaluated on balloon dilation catheters used as vascular pedicle models. Laparoscopic knots were tied in a laparoscopic box trainer. Knot constructs were pressure tested to failure. Results were compared by Kruskal-Wallis and Steel-Dwass comparisons.
RESULTS: Both MK and LMK had mean leakage pressures above 300 mm Hg. The MK leaked at higher pressure than all other knots, including the LMK (P < .001). The LMK leaked at greater pressures compared with the Sx and the LSx (P < .001). No difference was detected between leaking pressures of the Sx and the LSx (P = .226), with both leaking at pressures below 40 mm Hg.
CONCLUSION: The LMK created a more secure first throw compared with the Sx and leaked at supraphysiologic pressures.
CLINICAL SIGNIFICANCE: The LMK has excellent knot holding strength on a vascular pedicle model and may be further evaluated for clinical application.
STUDY DESIGN: Experimental study.
SAMPLE POPULATION: Ten constructs each of the Miller's knot and surgeon's throw performed openly and laparoscopically with 2-0 polyglyconate suture.
METHODS: Knot holding strengths of the LMK, MK, LSx, and Sx knots were evaluated on balloon dilation catheters used as vascular pedicle models. Laparoscopic knots were tied in a laparoscopic box trainer. Knot constructs were pressure tested to failure. Results were compared by Kruskal-Wallis and Steel-Dwass comparisons.
RESULTS: Both MK and LMK had mean leakage pressures above 300 mm Hg. The MK leaked at higher pressure than all other knots, including the LMK (P < .001). The LMK leaked at greater pressures compared with the Sx and the LSx (P < .001). No difference was detected between leaking pressures of the Sx and the LSx (P = .226), with both leaking at pressures below 40 mm Hg.
CONCLUSION: The LMK created a more secure first throw compared with the Sx and leaked at supraphysiologic pressures.
CLINICAL SIGNIFICANCE: The LMK has excellent knot holding strength on a vascular pedicle model and may be further evaluated for clinical application.