Tissue Response to Surgical Energy Devices

Phillips, Courtney K.; Hruby, Gregory W.; Durak, Evren; Lehman, Daniel S.; Humphrey, Peter A.; Mansukhani, Mahesh; Landman, Jaime

doi:10.1016/j.urology.2007.11.035

Cited by 94 publications

(74 citation statements)

References 5 publications

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“…In a previous study, Phillips et al [22] tested the tissue response to surgical energy devices in a porcine model. A fullthickness lateral energy spread caused by BP compared with that caused by UC was statistically higher in the arteries (4.5 vs. 0.6 mm) and the veins (5.5 vs. 1.5 mm) for each sample.…”

Section: Discussionmentioning

confidence: 99%

Histopathological Response and Adhesion Formation After Omentectomy with Ultrasonic Energy, Bipolar Sealing, and Suture Ligation

2013

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This study was designed to evaluate the histopathological response and intra-abdominal adhesion formation after an omentectomy in rats using the bipolar vesselsealing device, ultrasonic coagulator, and suture ligation techniques. Forty Wistar albino rats were used, divided into four random groups. The rats underwent a midline laparotomy, and a partial omentectomy was performed using a 3-0 silk suture with suture ligation in group 1, bipolar device in group 2, and ultrasonic coagulator in group 3; only a laparotomy was performed on the control group. Lateral thermal damage was examined the same day, and a piece of the omentum was left in the animals to be examined on postoperative day 15. A relaparotomy was performed to assess adhesion formation and histopathological response.

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Section: Discussionmentioning

confidence: 99%

Histopathological Response and Adhesion Formation After Omentectomy with Ultrasonic Energy, Bipolar Sealing, and Suture Ligation

2013

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“…With greater pressure, there is more cutting but less tissue coagulation. Ultrasonic devices produce less heat than electrosurgery [16,17,38,48,49], and can be used to coagulate tissue, and are documented to divide blood vessels up to 5mm [39]. e mechanism of tissue temperature rise is di erent to electrosurgery.…”

Section: Ultrasonic Dissectionmentioning

confidence: 99%

“…An alternative technique for surgical dissection is ultrasonic dissection (UD) which uses mechanical energy from vibrations at 55 kHz that disrupt the hydrogen bonds in tissue proteins and leads to division of the tissue. ere are con icting results according collateral thermal spread from EBDs, some have conlcuded a reduced propensity to cause collateral thermal damage in UD [15,16] [17] compared to ES.…”

Section: Introductionmentioning

confidence: 99%

Energy based surgical instruments : With particular focus on collateral thermal injury

Carlander¹

2015

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“…13 Ultrasonic-based devices have been shown to produce less thermal spread than RF devices. 14,15 However, the active jaw of ultrasonic devices can reach temperatures in excess of 200°C (Refs. 15 and 16) and take >20 s to cool to usable temperatures.…”

Section: Energy-based Surgical Devicesmentioning

confidence: 99%

“…17 Although RF devices are associated with larger thermal spread, their jaw temperatures are lower (<100°C) than ultrasonic devices. 15,16 These energy-based devices expedite normally labor-intensive surgical procedures, such as lobectomy, 18 nephrectomy, gastric bypass, 19 splenectomy, 20 thyroidectomy, 21 hysterectomy, 22 and colectomy. 23 However, both electrosurgical and ultrasonic devices have limitations, including the potential for undesirable charring and unnecessarily large collateral thermal damage zones (Table 1). 14,24,25…”

Section: Energy-based Surgical Devicesmentioning

confidence: 99%

Rapid sealing and cutting of porcine blood vessels,ex vivo, using a high-power, 1470-nm diode laser

et al. 2014

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Abstract. Suture ligation with subsequent cutting of blood vessels to maintain hemostasis during surgery is time consuming and skill intensive. Energy-based electrosurgical and ultrasonic devices are often used to replace sutures and mechanical clips to provide rapid hemostasis and decrease surgery time. Some of these devices may create undesirably large collateral zones of thermal damage and tissue necrosis, or require separate mechanical blades for cutting. Infrared lasers are currently being explored as alternative energy sources for vessel sealing applications. In a previous study, a 1470-nm laser was used to seal vessels 1 to 6 mm in diameter in 5 s, yielding burst pressures of ∼500 mmHg. The purpose of this study was to provide vessel sealing times comparable with current energy-based devices, incorporate transection of sealed vessels, and demonstrate high vessel burst pressures to provide a safety margin for future clinical use. A 110-W, 1470-nm laser beam was transmitted through a fiber and beam shaping optics, producing a 90-W linear beam 3.0 by 9.5 mm for sealing (400 W∕cm 2 ), and 1.1 by 9.6 mm for cutting (1080 W∕cm 2 ). A two-step process sealed and then transected ex vivo porcine renal vessels (1.5 to 8.5 mm diameter) in a bench top setup. Seal and cut times were 1.0 s each. A burst pressure system measured seal strength, and histologic measurements of lateral thermal spread were also recorded. All blood vessels tested (n ¼ 55 seal samples) were sealed and cut, with total irradiation times of 2.0 s and mean burst pressures of 1305 AE 783 mmHg. Additional unburst vessels were processed for histological analysis, showing a lateral thermal spread of 0.94 AE 0.48 mm (n ¼ 14 seal samples). This study demonstrated that an optical-based system is capable of precisely sealing and cutting a wide range of porcine renal vessel sizes and, with further development, may provide an alternative to radiofrequency-and ultrasonic-based vessel sealing devices.

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Tissue Response to Surgical Energy Devices

Cited by 94 publications

References 5 publications

Histopathological Response and Adhesion Formation After Omentectomy with Ultrasonic Energy, Bipolar Sealing, and Suture Ligation

Histopathological Response and Adhesion Formation After Omentectomy with Ultrasonic Energy, Bipolar Sealing, and Suture Ligation

Energy based surgical instruments : With particular focus on collateral thermal injury

Rapid sealing and cutting of porcine blood vessels,ex vivo, using a high-power, 1470-nm diode laser

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