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Therefore, it is uncertain as to whether the sticking results presented here could be applied to an in vivo operative context. Nonetheless, the ex vivo vessels in this experiment clearly showed less sticking to ENSEAL devices relative to LigaSure. This reduced sticking may contribute to the consistent sealing performance found over multiple firings with ENSEAL. The ENSEAL instruments Obeticholic Acid price contain an offset electrode configuration and positive temperature coefficient nanoparticles in the jaw (Figure 5A). This configuration minimizes thermal spread and sticking, while allowing complete hemostatic seals (Figure 5B). When the temperature in the jaw and tissue rises to approximately 100��C, the positive temperature coefficient polymer expands and the conductive chains break apart, thus interrupting the flow of electrical current and preventing further increases in temperature. Figure 5 ENSEAL jaw structure and vessel sealing. Although the scope of the current report was limited to key elements required for vascular sealing and hemostasis, published preclinical and clinical data have established the effectiveness of advanced bipolar sealing in vivo and are consistent Dolutegravir price with results presented here. Overhaus et al compared ENSEAL with conventional clamp and ligation for resection of bowel, colon, and kidney in a porcine model.20 Blood loss and operation time were significantly lower for the ENSEAL surgeries, and lateral thermal spread was 1 mm or less. Bibi et al found that human mesenteric arteries sealed with ENSEAL during laparoscopic colorectal surgery exhibited mean (ex vivo) burst pressures of �� 853 mmHg and lateral thermal damage CDK9 and pulsatile blood flow subjecting vessels to physiologic shear forces.10 However, the reproducibility and supraphysiologic burst pressures achieved with this approach provide a reliable index of the safety and consistency that devices will deliver in vivo. Other limitations include relatively small sample size and restriction to 5-mm-diameter vessels in the burst pressure analysis. Finally, it must be noted that this work was funded and performed by the manufacturer of the ENSEAL tissue sealing technology and all authors are employees of Ethicon, Inc. However, risk of bias was minimized by using a standardized preclinical model for all devices in the respective studies.