The only medical grade pump I have experience with is the ErecAid System Esteem manual VED
https://www.erecaidpumps.com/osbon-erecaid-esteem-manual-on-sale/. I've had it for a number of years and it has held up well with minor exceptions that haven't substantially effected it's function.
The release button for the constriction ring applicator broke but it's not necessary and the design could have done well without it. There is or was a little foam plug that I assume is to keep foreign matter out of the pump mechanism from within the tube. It repeatedly fell out until it was lost. I haven't noticed any negative effects from it's loss.
With the supplied tube I think it would max out at 8.25" or so in length. No more than that. Unfortunately that hasn't been an issue. It is just big enough for my girth at the opening but I'm girthy. The opening has an inside diameter of 2". It also comes with an insert that will reduce it about 1 3/4" if needed.
The model I have is manual but it works well enough that I really don't see much point in an electric model. It's easy to operate with one hand. I guess it could be an issue with more severe arthritis.
The vacuum release is conveniently located and easily operated with a finger of the hand you're holding the pump with. It releases the vacuum quickly and can easily be operated so as to give just a partial release if desired.
This VED does not have a gauge and I don't think there is really a practical way to add one. Well, I suppose I could drill a hole near the top of the tube and ....... You get the idea. Jeez! I'm sorry I even let my mind drift off that way. Well, anyhow, I haven't really seen much need. I pump until it's a bit uncomfortable and then back off a smidge. That seems to work just fine.
This pump is a medical grade pump and I don't know the current price. I'm sure it costs more than it should but it is certainly better quality than the novelty pumps I've seen.
I've also tried a couple of novelty (sex shop) pumps. The quality of the ones I tried weren't in the same ball park at all.
I won't claim the VED I have is the best one. It's the only medical grade VED I've tried. Others could be much better or maybe just a better value.
YMMV