New Harmonic Scalpel versus Conventional Hemostasis in Right Colon Surgery: A Prospective Randomized Controlled Clinical Trial

Abstract

Background: The Harmonic Scalpel (HS) is a device that uses vibrations to coagulate and cut tissues simultaneously. Its advantages are represented by minimal lateral thermal tissue damage, less smoke formation, no neuromuscular stimulation and no transmission of electricity to the patient. Methods: A total of 211 consecutive patients (113 men, 98 women; mean age 64 years) undergoing hemicolectomy for cancer of the right colon were divided into two groups, namely those in whom the operation was performed using a new HS handpiece (NHS; 108 patients) and those assigned to conventional hemostasis (CH; 103 patients). The two surgical groups were compared regarding patients' age and sex, tumor size, location, histotype and local invasiveness assessed by American Joint Cancer Committee stage, operative time, fluid content in the suction balloon (drainage volume) during the first 1-3 days after surgery, hospital stay and complications. Results: Ultrasonic energy delivered through an HS has been shown to be safe and to produce minimal damage to the surrounding tissues because of its minimal heat production. Electrical devices allow hemostatic control in vessels up to 3 mm in diameter, while HS can coagulate vessels up to 5 mm in diameter; thus, HS allows not only better control of bleeding but also of lymphorrhea. In fact, the amount of fluid collected in the drainage was significantly lower in the NHS group compared to the CH group. Protein depletion influences the patient's regenerative capacity and thus also the occurrence of complications and recovery time. Conclusion: NHS is a useful device in colon surgery; it facilitates surgical maneuvers and reduces operative times and blood and lymphatic losses, allowing satisfactory maintenance of protein storage. This results in a lower incidence of complications and faster recovery by patients.

The Treatment of Giant Periurethral Condyloma in Pregnancy Using an Ultrasonic Thermal Scalpel: A Case Report and New Single Session Treatment Option

“…The device offers the advantages of causing minimal lateral thermal damage and producing lesser smoke. In addition, the device avoids the passage of electrical current and neuromuscular stimulation [ 5 ]. To our knowledge, the Harmonic Scalpel (HS) has not been previously used for the treatment of a giant periurethral condyloma in the presence of a healthy intrauterine pregnancy.…”

Management of OSAS: The ELIBA® Device Can Help the Patient?

“…The tongue and neck muscles are related by way of proprioception via a common trunk from the ansa cervicalis through the hypoglossal nerve [29]. Currently, tongue position studies have suggested that it may not be possible to improve OSAS, at least not without difficult-to-use devices, because it is related to a subcortical abnormality, specifically in the ventral part of the rostral brainstem [30,31].…”

Ultrasonic Dissection versus Conventional Dissection for Pancreatic Surgery: A Meta-Analysis

“…Inoue et al showed in a prospective randomized study that ultrasonic scalpel could significantly shorten operation time and decrease intraoperative blood loss for open gastric cancer surgery [ 12 ]. One RCT conducted by Sista et al reported that the use of a harmonic scalpel was associated with reduced operation time and less blood loss in right colon surgery [ 13 ]. Using the UD device in axillary dissection also decreased blood loss in comparison with CD [ 30 ].…”

“…Due to this advantage, the device has been widely employed in the field of laparoscopic surgery. Many studies have reported the safety and usefulness of UD device in open surgical procedures including hemorrhoidectomy [ 10 ], thyroidectomy [ 11 ], and gastric [ 12 ], colorectal [ 13 ], and hepatic surgery [ 14 ]. The application of UD device has also been investigated in pancreatic surgery [ 15 – 20 ].…”