The Vitro Study Of Two New Laparoscopic Hemostasis Suture-knot-tying Techniques

Objective:The research is mainly to establish a laparoscopic vascular suture system,to study the effectiveness and safety of two new laparoscopic knotting methods,and to explore the learning curve of these two kinds of knotting ways.Methods:After the preparation of laparoscopic simulation training box and the establishment of a simulated vascular suture system,16 experimental workers were divided into four groups:4 in High-aged laparoscopic group,4 in middle-aged laparoscopic group,4 in primary laparoscopic group,4 in non-experienced laparoscopic group.Each person practiced 10 tensive knot and continuous suture.The learning curve was obtained by comparing the learning time of the non-experienced group.After grasping the two new knotting methods,the speed test of classical method,tensive knot and continuous suture were carried out.The bleeding volume in the process of knot formation,the first knot safety test,the knot resistance traction test and the suture position tensive test were also carried out.At last,the validity and safety of tensive junction and continuous suture were observed through the experiments.Results:An economical and effective laparoscopic training box and a simulated vascular suture system were established.In the non-experienced group,the people using the tensive method entered the platform stage at about fifth times,the people using the continuous suture entered the platform stage at about sixth times.In the validation experiment of tensive knot and continuous suture,compared with ordinary tensive knot,there was a significant difference in the speed between tensive junction and continuous suture(p<0.05).In the comparison of bleeding volume between the three knotting methods,the bleeding volume of high and middle-aged doctors in tensive and continuous suture was significantly less than that in simple suture(p<0.05).In low,non-experienced group,the bleeding volume of tensive knot and continuous suture was larger than that of simple suture.In the first knot safety comparison between the three knotting methods,the bleeding volume of single continuous sutures was less than the classic knot and tensive knot(p<0.05),and there was no significant difference between the tensive knot and the classic knot(p>0.05).The tensile effect of tensive and continuous suture is better than that of simple suture in the three types of knot resistance test.There was no significant difference in the pressure difference between the three knotting methods(P>0.05)in the stress resistance experiments.Conclusion:the self-made laparoscopic simulation training box and the simulated vascular suture system are low cost and can be used in the clinical simulation of vascular suture.The tensive knot and continuous suture are effective and safe,which can be accepted,appreciated,advocated and promoted.