CASE REPORTS   

Chirurgia 2014 February;27(1):19-20

Copyright © 2014 EDIZIONI MINERVA MEDICA

language: English

Insufficient LigaSure vessel seal in a vascular type Ehlers-Danlos patient

Jalink M. B. ³, Tielliu I. F. J. ¹, Krikke C. ³, Jansen L. ²

¹ Department of Abdominal Surgery, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands; ² Department of Vascular Surgery University Medical Center Groningen Groningen, the Netherlands; ³ Division of Surgical Oncology Department of Surgery, University of Groningen, University Medical Center Groningen Groningen, the Netherlands

During a laparotomy in a patient with vascular type Ehlers-Danlos (former type IV) syndrome, we discovered that the LigaSure vessel sealing system did not produce the desired mesenteric vessel seal. We hypothesize that this was due to the defect in type III collagen, as has been described in vascular type Ehlers-Danlos patients. Type III collagen is also one of the proteins that play a role in the seal that is formed by the heat produced by the LigaSure. The defect seems to result in an inadequate blood vessel seal and subsequent arterial bleeders. Therefore, we advise not to use the LigaSure system in vascular type Ehlers-Danlos patients and to ligate the mesentery in these patients with sutures instead.