Can LigaSure™ be used to perform sleeve gastrectomy? - Tensile strength and histological changes.

INTRODUCTION: LigaSure™ was developed as an alternative to suture ligatures, hemoclips and staplers for ligating vessels and tissue bundles. The aim of the present study was to determine whether LigaSure can be used as a welding instrument in the performance of laparoscopic sleeve gastrectomy. MATERIAL AND METHODS: Gastric specimens were assigned into four groups. Group 1 - specimens remained with the staple line intact. Group 2 - the staple line was oversewn. Group 3 - the staple line was resected with LigaSure. Group 4 - staple line was resected with LigaSure and the seal was oversewn. In all specimens the pressure tolerance was assessed using a portable sensor. RESULTS: In group 1 the leak pressure was 34.7 ± 11.7 whereas in group 2 specimens the pressure increased three-fold (101.9 ± 21.4). The LigaSure seal alone (group 3) achieved a mean pressure of 13.7 mmHg. However, in group 4 there was an exponential increase on their burst strength up to 142 mmHg (p = 0.0005). CONCLUSION: According to our results, LigaSure could be used to perform laparoscopic sleeve gastrectomy with reduction of staple-line bleeding and, when reinforced with a running suture, it achieves a strength that approaches that of staples plus oversewing.

Screen-Printed High-Performance Flexible Electrothermal Films Based on Three-Dimensional Intercalation Graphene Nanosheets/MWCNT/Carbon Black Composite.

A liquid-phase stripping method was used to strip the graphite under the action of mechanical shear force to prepare graphene nanosheets (GNSs) on a large scale. Given the multicomponent composite conductive particles formed by GNSs with acid-treated MWCNTs (f-MWCNTs) and carbon black (CB), the three-dimensional (3D) intercalation electrothermal composite of GNSs/MWCNTs/CB with excellent conductivity and mechanical properties was prepared with water-based acrylic resin as a connector. Carbon particles (16.97 wt %) are found in the composite and the sheet resistance (Rs) is only 4 Ω sq-1 as f-MWCNTs and CB intercalations form a more stable 3D conducting medium between the GNSs. The flexible electrothermal film (2.5 cm × 2.5 cm) printed with the 3D intercalation GNSs/MWCNTs/CB composite had a saturation temperature (Ts) of 175 °C with an input of 3 V and lower power consumption (249.87 cm2 W-1). It only takes 10 s to reach Ts and the electrical performance is still intact under the pressure of 1 × 105 kPa. After being bent 2500 times (bending radius is 5 mm), the electrothermal performance of the flexible electrothermal film remained stable.