比較不同類型之血管夾及縫線組合之間的維持張力

謝宗頤、楊宇祥、陳至亨、闕士傑

國立台灣大學附設醫院 泌尿部

Comparison of Holding Strength on ligation Clips with Various Suture Types

Tsung-Yi Hsieh, Yu-Hsiang Yang, Chih-Heng Chen, Shih-Chieh Jeff Chueh

Department of Urology, National Taiwan University Hospital

Purpose: Sliding-clip renorrhaphy using ligation clips as a substitute for suture anchors is an important technique among open, laparoscopic, and robotic partial nephrectomy. However, the tensile strength of this technique may be influenced by different ligation clips or sutures. We aim to evaluate the holding strengths of ligation clips (Hem-o-lok, Inno-hook clips) on various sutures (Vicryl, V-loc) and determine the optimal combination of surgical clips and suture type for the anchoring system.

Materials and Methods: One or two ligation clips were attached 1 cm from the end of the suture as an anchor. A tensile testing system was used to provide a constant velocity to pull on the free end of the suture. The maximal holding strength of clips with suture were measured in Newtons (N) by a digital force gauge.

We divided the ligation clips into groups by number (1 or 2 clips), size [large (L) or medium-large (ML)] and material (Hem-o-lok or Inno-hook clips). The 3-O Vicryl or V-loc sutures combined with each group of ligation clips were tested (n = 3 for each combination, total 48 experiments).

Results: Higher maximal holding strength was found in this anchoring system with 3-O V-loc suture than with 3-O Vicryl suture regardless of ligation clip groups. Among the anchoring systems with 3-O V-loc suture, the maximal holding strength of 2 L-sized hemo-o-lok (5.58 ± 1.39 N) or Inno-hook clips (4.57 ± 1.78 N) were significantly higher than other settings (from 2.37 to 3.01 N, p = 0.005). There was no obviously significant difference in maximal holding strength between 2 L-sized hemo-o-lok or Inno-hook clips combined with 3-O V-loc suture.

Conclusions: Our study revealed that 3-O V-loc with 2 L-sized Hemo-o-lok or Inno-hook clips provided superior maximal holding strength in this anchoring system.