Laminar and turbulent surgical plume characteristics generated from curved- and straight-blade laparoscopic ultrasonic dissectors

Kim, Fernando J.; Sehrt, Daniel; Pompeo, Alexandre; Molina, Wilson

doi:10.1007/s00464-013-3369-6

Cited by 5 publications

(8 citation statements)

References 6 publications

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“…The SCUD performed similarly to the Harmonic ACE for vessel sealing times, burst pressures, collateral thermal damage, and seal failure rates in vivo in pigs . The SCUD had significantly decreased surgical smoke production compared to Harmonic ACE in ex vivo studies . Clinically, SCUD was successfully applied in a laparoscopic nephrectomy and a lymphadenectomy procedure in people .…”

Section: Introductionmentioning

confidence: 99%

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Cordless ultrasonic dissector versus advanced bipolar vessel sealing device for laparoscopic ovariectomy in dogs*

et al. 2017

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Section: Introductionmentioning

confidence: 99%

“…20,21 The SCUD had significantly decreased surgical smoke production compared to Harmonic ACE in ex vivo studies. 22,23 Clinically, SCUD was successfully applied in a laparoscopic nephrectomy and a lymphadenectomy procedure in people. 24 No data are available on the use of SCUD in dogs.…”

Section: Introductionmentioning

confidence: 99%

Cordless ultrasonic dissector versus advanced bipolar vessel sealing device for laparoscopic ovariectomy in dogs*

et al. 2017

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“…Despite utilizing the same ultrasonic innovation, it has been reported that the cutting edge geometry of the device also affects the smoke production 11. USADs with straight sharp edges have more reliable oscillations and create more laminar flow than those with curved blades.…”

Section: Resultsmentioning

confidence: 99%

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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“…Laminar flow causes minimal visual obstruction by directing the aerosol downwards and dissipates immediately, while turbulent plume is directed erratically across the cavity. It causes maximum obstruction 0.3 s after activation and clears after 2 s. Ultrasonic dissectors with straight blades have more consistent oscillations and generate more laminar flow compared with curved blades [17] (Fig. 2).…”

Section: Cordless Uss Improvises Agility and Handlingmentioning

confidence: 99%

“…SonoSurg generated negligible plume obstruction (0.21 % of operating field), while Sonicision obstructed 4.8 % of operating field and ACE 26.63 % [16]. Kim et al [17] went on to identify two types of plume generations based on the blade geometry as well. Laminar flow causes minimal visual obstruction by directing the aerosol downwards and dissipates immediately, while turbulent plume is directed erratically across the cavity.…”

Section: Cordless Uss Improvises Agility and Handlingmentioning

confidence: 99%

Surgical Efficacy Among Laparoscopic Ultrasonic Dissectors: Are We Advancing Safely? A Review of Literature

Devassy

Gopalakrishnan

Wilde

2015

J Obstet Gynecol India

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The specialty of laparoscopy has evolved with the advent of new technologies over the last few years. Energy-based devices and Ultrasonic dissectors are used with a lot of factors in play-including ergonomics and economics during surgery. Here an attempt is based to review the surgical efficacy and safety of these dissectors with importance to plume production and lateral thermal damage. The factors contributing to adversities to the dissectors are also to be noted. The strategy adopted was aimed at finding relevant studies from PubMed from 1995 to 2014. The basic principle of plume production and thermal damage are studied in this review. Factors contributing to the same that can lead to adversities during laparoscopic surgeries are identified. Summarizing key points that increase lateral thermal damage and plume production amongst different ultrasonic shears and suggesting a technique to identify the right balance between the existing dissectors was possible. The RF Device and USS are both useful and widely used and are more safer than monopolar devices. RF Device is considerably slower than USS, as it cannot achieve coagulation and cutting at the same time. Although USS definitely improvises dissection and has less thermal injury than RF Device, the clinical implications in balancing dissection efficacy with hemostasis need to be investigated further. The ideal haemostatic energy-based shear device would be one with excellent hemostatic results and visual acuity while allowing none or minimal thermal energy escape at the point of application. In our current setting, a combined use of both RF and USS device usage as applied in the particular situations has potential.

show abstract

Laminar and turbulent surgical plume characteristics generated from curved- and straight-blade laparoscopic ultrasonic dissectors

Cited by 5 publications

References 6 publications

Cordless ultrasonic dissector versus advanced bipolar vessel sealing device for laparoscopic ovariectomy in dogs*

Cordless ultrasonic dissector versus advanced bipolar vessel sealing device for laparoscopic ovariectomy in dogs*

Laparoscopic ultrasonic dissectors: technology update by a review of literature

Surgical Efficacy Among Laparoscopic Ultrasonic Dissectors: Are We Advancing Safely? A Review of Literature

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