{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T01:41:12Z","timestamp":1789004472506,"version":"build-2803163510"},"reference-count":33,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2018,9,4]],"date-time":"2018-09-04T00:00:00Z","timestamp":1536019200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Veterinary Surgery"],"published-print":{"date-parts":[[2018,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To determine the number of use\/cleaning\/resterilization cycles that can be safely applied to a vessel sealing device intended for single use (LigaSure).<\/jats:p><\/jats:sec><jats:sec><jats:title>Study design<\/jats:title><jats:p>Ex vivo study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Sample population<\/jats:title><jats:p>LigaSure Small Jaw handsets (n\u2009=\u20096) and LigaSure Impact handsets (n\u2009=\u20096).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Handsets underwent simulated splenectomy\/cleaning\/resterilization cycles until failure, defined as leaking vascular seal or blade retraction failure. Functional testing included assessment of vascular seal integrity, handset activation\/tissue release, and cutting blade wear\/retraction. Vascular seal failure was defined as a leak occurring at &lt;300\u2009mm Hg. Cycles to failure were recorded. Sealed vessels were evaluated by histology at first handset use and failure.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Vascular seals created with the Small Jaw handset failed at a mean (95% CI) of 17.2 cycles (9.6\u201024.8) and a minimum of 10 cycles. Vascular seals created with the Impact failed at a mean of 20 cycles (18.4\u201021.6) and a minimum of 17 cycles. The majority of seal failures (73%; 95% CI 39%\u201094%) immediate leaked during vessel filling. The rate of vascular seal failure increased after the initial failure. Failure was associated with histologic disparities in tissue apposition.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Repeated use and resterilization resulted in failure of the vascular seal due to inadequate tissue apposition after a minimum of 10 cycles.<\/jats:p><\/jats:sec><jats:sec><jats:title>Clinical significance<\/jats:title><jats:p>Surgeons reusing and resterilizing LigaSure handsets (ForceTriad platform) should consider discarding handsets after 9 cycles for the Small Jaw and after 16 cycles for the Impact. Handsets should be immediately discarded after any intraoperative identification of vascular seal failure.<\/jats:p><\/jats:sec>","DOI":"10.1111\/vsu.12948","type":"journal-article","created":{"date-parts":[[2018,9,4]],"date-time":"2018-09-04T17:44:50Z","timestamp":1536083090000},"page":"951-957","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Influence of multiple reuse and resterilization cycles on the performance of a bipolar vessel sealing device (<scp>L<\/scp>iga<scp>S<\/scp>ure) intended for single use"],"prefix":"10.1111","volume":"47","author":[{"given":"Alexandra","family":"Kuvaldina","sequence":"first","affiliation":[{"name":"Cornell University Hospital for Animals  Ithaca New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1365-3284","authenticated-orcid":false,"given":"Galina","family":"Hayes","sequence":"additional","affiliation":[{"name":"Cornell University Hospital for Animals  Ithaca New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia","family":"Sumner","sequence":"additional","affiliation":[{"name":"Cornell University Hospital for Animals  Ithaca New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erica","family":"Behling\u2010Kelly","sequence":"additional","affiliation":[{"name":"Cornell University Hospital for Animals  Ithaca New York"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,9,4]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1586\/17434440.2015.985650"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-007-9390-x"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-007-9384-8"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-012-2285-5"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1053\/jvet.2002.33482"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-950X.2003.00574.x"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-950X.2006.00151.x"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cveq.2006.08.006"},{"key":"e_1_2_6_10_1","first-page":"737","article-title":"Standing laparoscopic ovariectomy technique with intra\u2010abdominal dissection for removal of large pathologic ovaries in mares","volume":"39","author":"Bont MP","year":"2010","journal-title":"Vet Surg"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-950X.2010.00719.x"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-950X.2010.00720.x"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-950X.2010.00721.x"},{"key":"e_1_2_6_14_1","first-page":"102","article-title":"Laparoscopic ovariectomy in dogs: a comparison of the LigaSure and the SonoSurg systems","volume":"40","author":"Ohlund M","year":"2011","journal-title":"J Small Anim Pract"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-950X.2010.00757.x"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1748-5827.2011.01040.x"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-950X.2011.00984.x"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1024\/0036-7281\/a000349"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-950X.2012.01007.x"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-950X.2013.12073.x"},{"key":"e_1_2_6_21_1","volume-title":"LigaSure Curved, Small Jaw, Open Sealer\/Divider Instruction Manual (LF1212A)","year":"2014"},{"key":"e_1_2_6_22_1","volume-title":"LigaSure Impact, Curved, Large Jaw, Open Sealer\/Divider Instruction Manual (LF4318)","year":"2014"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/vsu.12648"},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.1089\/lap.2009.0438"},{"key":"e_1_2_6_25_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-950X.2014.12215.x"},{"key":"e_1_2_6_26_1","doi-asserted-by":"publisher","DOI":"10.1590\/S0102-67202013000300014"},{"key":"e_1_2_6_27_1","doi-asserted-by":"publisher","DOI":"10.1136\/vr.100601"},{"key":"e_1_2_6_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2006.12.046"},{"key":"e_1_2_6_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjsurg.2010.10.016"},{"key":"e_1_2_6_30_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-012-2289-8"},{"key":"e_1_2_6_31_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10151-008-0405-y"},{"key":"e_1_2_6_32_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-005-0380-6"},{"key":"e_1_2_6_33_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-002-8833-7"},{"key":"e_1_2_6_34_1","volume-title":"Guidance for Industry and FDA Reviewers. 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