Strength and Persistence of Energy-Based Vessel Seals Rely on Tissue Water and Glycosaminoglycan Content.

Vessel ligation using energy-based surgical devices is steadily replacing conventional closure methods during minimally invasive and open procedures. In exploring the molecular nature of thermally-induced tissue bonds, novel applications for surgical resection and repair may be revealed. This work presents an analysis of the influence of unbound water and hydrophilic glycosaminoglycans on the formation and resilience of vascular seals via: (a) changes in pre-fusion tissue hydration, (b) the enzymatic digestion of glycosaminoglycans (GAGs) prior to fusion and (c) the rehydration of vascular seals following fusion.

Tissue storage ex vivo significantly increases vascular fusion bursting pressure.

Introduction: Harvested biological tissue is a common medium for surgical device assessment in a laboratory setting; this study aims to differentiate between surgical device performance in the clinical and laboratory environments prior to and following tissue storage. Vascular tissue fusion devices are sensitive to tissue-device temperature gradients, tissue pre-stretch in vivo and tissue water content, each of which can vary during tissue storage. In this study, we compare the results of tissue fusion prior to and following storage using a standardized bursting pressure protocol.

Evaluating temperature and duration in arterial tissue fusion to maximize bond strength.

Tissue fusion is a growing area of medical research that enables mechanical closure of tissues without the need of foreign bodies such as sutures or staples. Utilizing heat and pressure applied for a specified time, a bond can be formed between adjacent tissues. The success or failure of tissue fusion is contingent upon the strength of the bond it creates between opposing tissues, yet little characterization has been done to measure the strength of this interface as a function of the input parameters, such as heat and pressure.

Temperature measurement methods during direct heat arterial tissue fusion.

Fusion of biological tissues through direct and indirect heating is a growing area of medical research, yet there are still major gaps in understanding this procedure. Several companies have developed devices which fuse blood vessels, but little is known about the tissue's response to the stimuli. The need for accurate measurements of tissue behavior during tissue fusion is essential for the continued development and improvement of energy delivery devices.