Efficacy and Safety of Combined Ultrasonic and Bipolar Energy Source in Laparoscopic Surgery

Steinemann, Daniel C.; Lamm, Sebastian H.; Zerz, Andreas

doi:10.1007/s11605-016-3217-9

Cited by 8 publications

(4 citation statements)

References 23 publications

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“…Surgical smoke produced by electrocautery is composed of tissue detritus, volatile organic hydrocarbons, toluene and methyl propene and other carcinogenic particles, while aerosol particles produced by USADs contain a higher amount of cells, tissue and blood detritus 18,29. During onco-logical surgery, the presence of intact cancer cells in the smoke that in turn could spread the tumor into the abdominal cavity is a matter that is not yet well investigated 30. Although advanced USADs generate less surgical aerosol, it impairs the visibility during laparoscopy, requiring frequent cleaning of the scope to remove the adhering particles, frequent cleaning of the scope is required, affecting safety and surgical time 6,25,31.…”

Section: Discussionmentioning

confidence: 99%

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Laparoscopic ultrasonic dissectors: technology update by a review of literature

Devassy¹,

Hanif²,

Krentel³

et al. 2018

MDER

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The evolution of minimally invasive surgery has brought forward the appearance of new advances in the course of the most recent couple of years and has introduced energy-based devices. The newest among them today are the ultrasonically activated devices, which are utilized with a great deal of components in-play, including ergonomics and financial aspects amid surgery. The methodology embraced was finding significant investigations through studies from PubMed, Medline and Google Scholar on current ultrasonic dissectors, which are Ethicon’s Harmonic Scalpel (ACE®), Covidien’s Sonicision™ (SNC), Conmed’s SonoSurg® (SS) and Olympus’s Thunderbeat®, to describe their efficacy in terms of vessel sealing speed, vessel burst pressure, visibility, operation time and thermal speed. We found postmarketing evidence to determine which device exhibits the better performance. Animal studies showed that emissivity values and maximum temperatures for coagulation are similar among devices but maximum cutting temperatures are significantly different: ACE = 191.1°C, SNC = 227.1°C, SS = 184.8°C (p < 0.001). Cooling times are significantly different among devices: 35.7 s for ACE, 38.7 s for SNC and 27.4 s for SS (p < 0.001). Cooling times of passive jaws to reach 60°C after activation were also significantly different: 25.4 s for ACE, 5.7 s for SNC, and 15.4 s for SS (p < 0.001). The perfect device would unify brilliant hemostatic outcomes with visual sharpness while permitting none or insignificant thermal damage at the place of use.

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Section: Discussionmentioning

confidence: 99%

“…Additionally, it has been reported that inhalation of surgical smoke affects the health of surgeons 32,33. Therefore, it is recommended that surgical smoke should be removed and filtered during open and endoscopic procedures, as well prior to removing cannulas and trocars 30,32,33…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic ultrasonic dissectors: technology update by a review of literature

Devassy¹,

Hanif²,

Krentel³

et al. 2018

MDER

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“…The learning curve of residents for LA depends on the infrastructure of hospitality and surgical training. [ 6 7 8 ] There are many controversies in literature for minimal case or duration of experience in laparoscopy and prior experience of open appendectomy for safe LA; therefore, this study has been done. [ 9 10 ] This study aimed to determine the feasibility of safe LA performed by junior residents.…”

Section: Introductionmentioning

confidence: 99%

Feasibility of safe laparoscopic surgery performed by junior residents without exposure of open appendectomy: A retrospective study

Meena

Badkur

Rodha

et al. 2022

Journal of Family Medicine and Primary Care

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Context: Appendectomy is the most commonly performed surgery in the emergency department. It is very difficult to determine the minimal duration of the learning curve for junior residents to perform safe laparoscopic surgeries. Aim: This study aimed to determine the feasibility of a safe laparoscopic appendectomy performed by junior residents. Settings and Design: A retrospective study was conducted at a tertiary healthcare center from May 2018 to May 2020. Methods and Material: This study reviewed all the data of laparoscopic appendectomy performed by junior and senior residents. Both groups were compared for the patient outcome in terms of complications, conversion to open, intraoperative findings, operative time, postoperative progress, and hospital stay. Statistical Analysis: The data were formulated in an excel sheet and analyzed with SPSS. Mean, median, range, standard deviation, percentages, univariate analysis with χ test and t- test were used. Results: No significant difference was found in operative time (mean [SD], 84.87 [24.73] vs. 86.95 [24.93], P = 0.679), intraoperative complication (9.2% vs. 7.8%, P = 0.769), postoperative complications (34.2% vs. 34.4%, P = 0.984), conversion to open (6.6% vs. 4.7%, P = 0.633), length of postoperative hospital stay (Mean [SD], 2.3 [2] vs. 2.2 [1], P = 0.739), and readmission (4% vs. 3%, P = 0.794). No major intraoperative complications and mortality were found in both groups. Conclusions: Junior residents may be allowed for safe laparoscopic appendectomy under supervision without experience of open appendectomy. The patient’s outcomes may be comparable with surgery performed by well-experienced surgeons. They can improve the basic healthcare system in the future with feasible basic laparoscopic surgery for common diseases.

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“…1 Their use has been broadly reported for secondary hemostasis or cutdown dissection in different specialties, such as general surgery, dermatology, and gynecology. [2][3][4] However, such modalities have been associated with extensive thermal injury of adjacent tissue that prohibits their use in dissection near sensitive neurovascular anatomic structures, especially during specific vascular surgery procedures. 1,5 Carotid endarterectomy (CEA) remains a vascular surgery procedure that demands precision and surgical skills.…”

mentioning

confidence: 99%

Utilization of low-temperature helium plasma (J-Plasma) for dissection and hemostasis during carotid endarterectomy

Filis

Galyfos

Sigala

et al. 2020

Journal of Vascular Surgery Cases, Innovations and Techniques

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Herein we report nine cases of carotid endarterectomy in which we used a cold atmospheric helium plasma device (J-Plasma; Apyx Medical Corporation, Clearwater, Fla). Although clinical reports are limited, experimental data indicate that this technology could be used for dissection and coagulation during surgery, yielding limited adjacent tissue damage. As a result, it could be extremely useful in procedures like carotid endarterectomy that necessitate careful dissection and coagulation with limited damage of adjacent neurovascular structures. (J Vasc Surg Cases and Innovative Techniques 2020;6:152-5.)

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Efficacy and Safety of Combined Ultrasonic and Bipolar Energy Source in Laparoscopic Surgery

Abstract: TB provides a reliable and effective hemostasis. However, ligation failure may occur. As with any kind of electrosurgery, the hot tip of the instruments bears the risk of potentially fatal thermal injuries.

Cited by 8 publications

References 23 publications

Laparoscopic ultrasonic dissectors: technology update by a review of literature

Laparoscopic ultrasonic dissectors: technology update by a review of literature

Feasibility of safe laparoscopic surgery performed by junior residents without exposure of open appendectomy: A retrospective study

Utilization of low-temperature helium plasma (J-Plasma) for dissection and hemostasis during carotid endarterectomy

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