Comparison of suture ligation, bipolar cauterization, and hemoclip ligation in the management of small branching vessels in a rat model.

Abstract

In elective microsurgical procedures, it is necessary to occlude small branches when mobilizing vessels in obtaining vein grafts. The purpose of this study was to evaluate the relative merits of suture ligation, bipolar cauterization, and hemoclip ligation, and to determine the minimum safe distance of occlusion. The left inferior epigastric vein and the right profunda femoris artery were ligated under operating microscope magnification with 10-0 nylon suture, small hemoclip, or bipolar cauterization at distances of 0, 1, or 2 mm from the parent vessel in 75 rats. Suture ligation was significantly better than bipolar cauterization (p less than .01) and hemoclip ligation (p less than .001). All cauterization failures occurred at 0 and 1 mm. Hemoclip failures occurred at all three distances. In the management of small branching vessels: suture ligation is safe at 0, 1, and 2 mm; bipolar cauterization is safe at 2 mm; and hemoclip ligation is unsafe.