Conventional electrocoagulation reaches its limitations when vessels with diameters exceeding around 2 mm are involved. In this case, haemostasis and a permanent seal can only be achieved with LIGATION bipolar vessel sealing. The bundle of vessels or tissue is gripped using a special instrument and pressed together by applying a predefined, constant pressure. Several automatically controlled current cycles then literally “weld” the two opposing vessel walls together.

It is not usually necessary to carry out detailed preparation of the vessels. Whole tissue bundles containing vessels can be simply gripped and sealed. The correct effect can be seen from the resulting milky appearance of the coagulation zone, within which the tissue can be severed safely. In individual cases it may be advisable to seal the tissue at two positions some distance apart and then make the incision between these two ligations.

Several studies have been conducted to determine whether vessels sealed in this way are closed securely. The results show that the bursting pressure is greater than 400 mmHg (reaching up to 900 mmHg) in more than 90 % of all cases, which as a rule is clearly above clinically observed blood pressure values.

In contrast to other procedures such as ligatures, purse-string sutures and clips, bipolar vessel sealing has the special advantages that preparation is fast, vessels are sealed quickly and securely, no foreign bodies are left in the operation region and costs are low. This leads to shorter operation times and less blood loss, in other words: it is easier on the patient. If NightKNIFE is used, the instrument’s integrated cutting function eliminates the annoying time losses normally incurred by having to change instruments. The savings in costs offered by the reusability are a strong economic incentive for using BOWA’s LIGATION instruments NightKNIFE, TissueSeal and LIGATOR. Possible applications of these sealing instruments include many kinds of open surgery and laparoscopic interventions in general surgery, gynaecology and urology.