Evaluation and Comparison of Contemporary Energy-Based Surgical Vessel Sealing Devices

Journal of Endourology
Zhamshid OkhunovJaime Landman

Abstract

We evaluated and compared five currently available energy-based vessel sealing devices to assess typical surgical metrics. We tested Caiman 5 (C5), Harmonic Scalpel Ace Plus (HA), Harmonic Ace +7 (HA7), LigaSure (LS), and Enseal G2 (ES) on small (2-5 mm), medium (5.1-7 mm), and large (7.1-9 mm) vessels obtained from 15 Yorkshire pigs. Vessels were randomly sealed and transected. We recorded sealing and transection time, charring and carbonization, thermal spread, and bursting pressure (BP). Specimens were sent for histopathologic evaluation of seal quality and thermal spread. A total of 246 vessels were evaluated: 125 were arteries and 121 were veins. There was no difference in BPs for small size arteries. For medium arteries, C5 provided the highest BP (proximal and distal jaw), followed by HA7, ES, LS, and HA [1740, 1600, 1165, 1165, 981, and 571 mm Hg, respectively, HA<C5-D(<0.001); HA<C5-P(<0.001); HA<ES(0.002); HA<HA7(0.002); HA7<C5-P(0.026); ES<C5-P(0.026); LS<C5-P(0.001); LS<C5-D(0.014)]. For large arteries, C5 and LS provided highest BP followed by HA7, ES, and HA [1676, 530, 467, 467, and 254 mm Hg, respectively, C5<HA(<0.001); C5<HA7(0.006); C5<ES(0.006); C5<LS(0.012)]. There were no bursting pressure failures for C5,...Continue Reading

References

Mar 1, 1985·Journal of Applied Physiology·J D MacDougallJ R Sutton
May 1, 1995·Archives of Physical Medicine and Rehabilitation·J A Narloch, M E Brandstater
Jun 5, 1998·Surgical Endoscopy·J S KennedyJ G Chandler
Jul 23, 2003·Surgical Endoscopy·P A CampbellA Cuschieri
Mar 17, 2007·Minimally Invasive Therapy & Allied Technologies : MITAT : Official Journal of the Society for Minimally Invasive Therapy·K EntezariR Van Velthoven
May 17, 2008·Surgical Endoscopy·William L NewcombDavid A Iannitti
Jul 10, 2012·Surgical Endoscopy·Deogracias A G ReyesAlfred Cuschieri

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Methods Mentioned

BETA
dissection

Software Mentioned

EnSeal
SYSTAT
Ligasure

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