Comparison of Two Different Energy-Based Vascular Sealing Systems for the Hemostasis of Various Types of Arteries: A Porcine Model—Evaluation of Ligasure ForceTriad™

Katsuno, Goutaro; Nagakari, Kunihiko; Fukunaga, Masaki

doi:10.1089/lap.2009.0438

Cited by 22 publications

(15 citation statements)

References 10 publications

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“…The use of vessel‐sealing devices (VSD) in laparoscopic surgery allows for rapid vascular sealing and tissue division, eliminating the requirement for surgical clips or ligatures . Vessel‐sealing devices use an energy platform to measure tissue impedance and direct the handset to apply high‐current/low‐voltage energy for tissue fusion . The applied energy denatures collagen and elastin within vessel walls, resulting in crosslinking of denatured proteins to form a vascular seal in vessels up to 7 mm in diameter .…”

Section: Introductionmentioning

confidence: 99%

Performance and microbiological safety testing after multiple use cycles and hydrogen peroxide sterilization of a 5‐mm vessel‐sealing device

et al. 2019

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Objective To evaluate the functional and microbiological safety of a single‐use laparoscopic vessel‐sealing device in a multiuse setting. Study design Ex vivo study. Sample population Twelve 5‐mm LigaSure Maryland jaw devices. Methods Handsets underwent repeated test cycles until failure. The handset packaging was opened, and handsets were agitated in phosphate‐buffered saline (PBS). The PBS was removed, centrifuged, and submitted for culture. Canine ovariectomy was simulated on cadaveric tissue, after which vascular seal quality was evaluated by pressure testing of sealed porcine carotid arteries. The handsets were cleaned and sterilized with hydrogen peroxide gas and repackaged. Results Mean ± SD cycles to failure was 7.7 ± 2.8, with a minimum of 4 and a maximum of 12 use cycles achieved. Eleven of the 12 handsets failed by failure of handset activation after depression of the activation trigger. Only 1 handset failed to hold an adequate vascular seal under 300 mm Hg of pressure. No handset exhibited positive bacterial culture at any cycle. Conclusion The sterilization method used in this study resulted in an excellent microbiological safety profile. Most of the handsets failed by activation button failure. Clinical significance Under the conditions of this study, hydrogen peroxide sterilization achieved microbiological safety. Handsets can successfully be reused until activation button failure without negative effects on the vascular seal or increased risk of infection to the patient.

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Section: Introductionmentioning

confidence: 99%

Performance and microbiological safety testing after multiple use cycles and hydrogen peroxide sterilization of a 5‐mm vessel‐sealing device

et al. 2019

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“…The energy platform (ForceTriad; Covidien Medtronic) measures tissue impedance and emits a sound cue when tissue impedance rises and the tissue is coagulated. This signals the surgeon to cut the vessel with the blade contained within the device hand piece, which positions the cut at the center of the formed seal . The device can provide permanent occlusion of vascular structures of up to 7 mm in diameter on each side of the cut .…”

Section: Introductionmentioning

confidence: 99%

Influence of multiple reuse and resterilization cycles on the performance of a bipolar vessel sealing device (LigaSure) intended for single use

et al. 2018

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“…The authors used a single electrosurgical generator and a single monopolar instrument in the study, and reported that V mode did not reduce the depth of thermal tissue spread compared with conventional continuous/interrupted waveforms [7]. The same advanced bipolar instrument (LigaSure Atlas TM ) was connected to 2 different ESUs (LigaSure TM Vessel Sealing unit and ForceTriad TM unit) in another study and the “vessel sealing” speed and lateral thermal spread were found to be statistically significant between the 2 ESUs [25]. Our study demonstrated that ESU used with monopolar systems and continuous/interrupted waveforms provided statistically significant results in terms of lateral thermal spread.…”

Section: Discussionmentioning

confidence: 99%

Comparison of the Thermal Spread of Three Different Electrosurgical Generators on Rat Uterus: A Preliminary Experimental Study

Karacan

Usta

Ozkaynak

et al. 2018

Gynecol Obstet Invest

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Background/Aims: The objective of this study was to compare the depth and width of thermal spread caused on rat uterine tissue after application of 3 different electrosurgical generators. Methods: Alsa Excell 350 MCDSe (Unit A), Meditom DT-400P (Unit M), and ERBE Erbotom VIO 300 D (Unit E) electrosurgical units (ESUs) were used. The number of Wistar Hannover rats required to obtain valid results was 10. The primary objective of the study was to compare the 3 ESUs using the same instrument and the same waveform. The secondary objective of the study was to compare the differences between monopolar and bipolar systems of each ESU separately using the same waveform. Results: The thermal spread caused by each ESU using monopolar instruments with continuous and interrupted waveforms was significantly different. Among the 3 devices, Unit A caused the largest thermal uterine tissue spread. On the other hand, Unit E caused the most superficial thermal tissue spread, and the smallest thermal spread among all ESUs. Conclusions: Surgeons should note that different ESUs used with the same power output might create different thermal effects especially in the monopolar configuration within the same waveform, for the same duration, and with the same instrument.

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Comparison of Two Different Energy-Based Vascular Sealing Systems for the Hemostasis of Various Types of Arteries: A Porcine Model—Evaluation of Ligasure ForceTriad™

Abstract: Both the LSAt and LSAtFT secured all vessel sizes to well above physiologic levels. The LSAtFT could be used more confidently in vessels up to 7 mm. Our findings indicate that LSAtFT could be a safer and more efficient instrument for advanced laparoscopic surgery.

Cited by 22 publications

References 10 publications

Performance and microbiological safety testing after multiple use cycles and hydrogen peroxide sterilization of a 5‐mm vessel‐sealing device

Performance and microbiological safety testing after multiple use cycles and hydrogen peroxide sterilization of a 5‐mm vessel‐sealing device

Influence of multiple reuse and resterilization cycles on the performance of a bipolar vessel sealing device (LigaSure) intended for single use

Comparison of the Thermal Spread of Three Different Electrosurgical Generators on Rat Uterus: A Preliminary Experimental Study

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