Comparison of four energy-based vascular sealing and cutting instruments: A porcine model

Aim To compare the safety and efficacy of four energy-based vascular sealing and cutting instruments. Methods Blood vessels of various types and diameters were harvested from four pigs using four instruments: Harmonic ACE™ (Ethicon Endo-Surgery, Cincinnati, OH), LigaSure™ V and LigaSure Atlas™ (Vall...

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Veröffentlicht in:Surgical endoscopy 2008-02, Vol.22 (2), p.534-538
Hauptverfasser: Person, Benjamin, Vivas, David A., Ruiz, Dan, Talcott, Michael, Coad, James E., Wexner, Steven D.
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container_end_page 538
container_issue 2
container_start_page 534
container_title Surgical endoscopy
container_volume 22
creator Person, Benjamin
Vivas, David A.
Ruiz, Dan
Talcott, Michael
Coad, James E.
Wexner, Steven D.
description Aim To compare the safety and efficacy of four energy-based vascular sealing and cutting instruments. Methods Blood vessels of various types and diameters were harvested from four pigs using four instruments: Harmonic ACE™ (Ethicon Endo-Surgery, Cincinnati, OH), LigaSure™ V and LigaSure Atlas™ (Valleylab, Inc., Boulder, CO; a division of Tyco Healthcare), and EnSeal™ vessel fusion system (SurgRx, Inc. Redwood City, CA). The diameters of the vessels, speed and adequacy of the cutting and sealing process, and bursting pressures were compared. An additional set of specimens was sealed and left in situ for up to 4 h after which the vessels were harvested and histopathologically analyzed for the degree of thermal injury. Results The bursting pressures were significantly higher with EnSeal™ compared to all other instruments ( p < 0.0001). The sealing process was significantly shorter with Harmonic ACE™ and significantly longer with LigaSure Atlas™ ( p
doi_str_mv 10.1007/s00464-007-9619-8
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Methods Blood vessels of various types and diameters were harvested from four pigs using four instruments: Harmonic ACE™ (Ethicon Endo-Surgery, Cincinnati, OH), LigaSure™ V and LigaSure Atlas™ (Valleylab, Inc., Boulder, CO; a division of Tyco Healthcare), and EnSeal™ vessel fusion system (SurgRx, Inc. Redwood City, CA). The diameters of the vessels, speed and adequacy of the cutting and sealing process, and bursting pressures were compared. An additional set of specimens was sealed and left in situ for up to 4 h after which the vessels were harvested and histopathologically analyzed for the degree of thermal injury. Results The bursting pressures were significantly higher with EnSeal™ compared to all other instruments ( p &lt; 0.0001). The sealing process was significantly shorter with Harmonic ACE™ and significantly longer with LigaSure Atlas™ ( p &lt;0.0001). The mean seal width was larger with the LigaSure Atlas™ compared to the other instruments, and it was smaller with EnSeal™ and Harmonic ACE™. Less radial adventitial collagen denaturation was present with EnSeal™ and LigaSure™ V than with the other two instruments; there were no significant differences in collagen denaturation although proximal thermal injury to the smooth muscle in the media of the vessel wall was less common with LigaSure Atlas™ than with the other instruments; however, the numbers were too small for statistical analysis. Conclusions The bursting pressures with EnSeal™ were significantly higher than with all the other instruments. Harmonic ACE™ was the fastest sealing instrument and LigaSure Atlas™ was slowest. EnSeal™ created less radial thermal damage to the adventitial collagen of the vessels and LigaSure Atlas™ created less thermal damage to the media of the vessels. The clinical significance of these findings is unknown.</description><identifier>ISSN: 0930-2794</identifier><identifier>EISSN: 1432-2218</identifier><identifier>DOI: 10.1007/s00464-007-9619-8</identifier><identifier>PMID: 18097720</identifier><identifier>CODEN: SUREEX</identifier><language>eng</language><publisher>New York: Springer-Verlag</publisher><subject>Abdominal Surgery ; Animals ; Biological and medical sciences ; Blood Vessels - pathology ; Electricity ; Equipment Design ; Gastroenterology ; General aspects ; Gynecology ; Hepatology ; Medical sciences ; Medicine ; Medicine &amp; Public Health ; Models, Animal ; Pressure ; Proctology ; Surgery ; Swine ; Vascular Surgical Procedures - instrumentation</subject><ispartof>Surgical endoscopy, 2008-02, Vol.22 (2), p.534-538</ispartof><rights>Springer Science+Business Media, LLC 2007</rights><rights>2008 INIST-CNRS</rights><rights>Springer Science+Business Media, LLC 2008</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c465t-344e27ce2fc322c75d9728e55411d7143b4abb98072ef94b4e0f216c95ccd3f93</citedby><cites>FETCH-LOGICAL-c465t-344e27ce2fc322c75d9728e55411d7143b4abb98072ef94b4e0f216c95ccd3f93</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00464-007-9619-8$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00464-007-9619-8$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27923,27924,41487,42556,51318</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&amp;idt=20139945$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/18097720$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Person, Benjamin</creatorcontrib><creatorcontrib>Vivas, David A.</creatorcontrib><creatorcontrib>Ruiz, Dan</creatorcontrib><creatorcontrib>Talcott, Michael</creatorcontrib><creatorcontrib>Coad, James E.</creatorcontrib><creatorcontrib>Wexner, Steven D.</creatorcontrib><title>Comparison of four energy-based vascular sealing and cutting instruments: A porcine model</title><title>Surgical endoscopy</title><addtitle>Surg Endosc</addtitle><addtitle>Surg Endosc</addtitle><description>Aim To compare the safety and efficacy of four energy-based vascular sealing and cutting instruments. Methods Blood vessels of various types and diameters were harvested from four pigs using four instruments: Harmonic ACE™ (Ethicon Endo-Surgery, Cincinnati, OH), LigaSure™ V and LigaSure Atlas™ (Valleylab, Inc., Boulder, CO; a division of Tyco Healthcare), and EnSeal™ vessel fusion system (SurgRx, Inc. Redwood City, CA). The diameters of the vessels, speed and adequacy of the cutting and sealing process, and bursting pressures were compared. An additional set of specimens was sealed and left in situ for up to 4 h after which the vessels were harvested and histopathologically analyzed for the degree of thermal injury. Results The bursting pressures were significantly higher with EnSeal™ compared to all other instruments ( p &lt; 0.0001). The sealing process was significantly shorter with Harmonic ACE™ and significantly longer with LigaSure Atlas™ ( p &lt;0.0001). The mean seal width was larger with the LigaSure Atlas™ compared to the other instruments, and it was smaller with EnSeal™ and Harmonic ACE™. Less radial adventitial collagen denaturation was present with EnSeal™ and LigaSure™ V than with the other two instruments; there were no significant differences in collagen denaturation although proximal thermal injury to the smooth muscle in the media of the vessel wall was less common with LigaSure Atlas™ than with the other instruments; however, the numbers were too small for statistical analysis. Conclusions The bursting pressures with EnSeal™ were significantly higher than with all the other instruments. Harmonic ACE™ was the fastest sealing instrument and LigaSure Atlas™ was slowest. EnSeal™ created less radial thermal damage to the adventitial collagen of the vessels and LigaSure Atlas™ created less thermal damage to the media of the vessels. 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Vivas, David A. ; Ruiz, Dan ; Talcott, Michael ; Coad, James E. ; Wexner, Steven D.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c465t-344e27ce2fc322c75d9728e55411d7143b4abb98072ef94b4e0f216c95ccd3f93</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2008</creationdate><topic>Abdominal Surgery</topic><topic>Animals</topic><topic>Biological and medical sciences</topic><topic>Blood Vessels - pathology</topic><topic>Electricity</topic><topic>Equipment Design</topic><topic>Gastroenterology</topic><topic>General aspects</topic><topic>Gynecology</topic><topic>Hepatology</topic><topic>Medical sciences</topic><topic>Medicine</topic><topic>Medicine &amp; Public Health</topic><topic>Models, Animal</topic><topic>Pressure</topic><topic>Proctology</topic><topic>Surgery</topic><topic>Swine</topic><topic>Vascular Surgical Procedures - instrumentation</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Person, Benjamin</creatorcontrib><creatorcontrib>Vivas, David A.</creatorcontrib><creatorcontrib>Ruiz, Dan</creatorcontrib><creatorcontrib>Talcott, Michael</creatorcontrib><creatorcontrib>Coad, James E.</creatorcontrib><creatorcontrib>Wexner, Steven D.</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing &amp; 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Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Surgical endoscopy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Person, Benjamin</au><au>Vivas, David A.</au><au>Ruiz, Dan</au><au>Talcott, Michael</au><au>Coad, James E.</au><au>Wexner, Steven D.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Comparison of four energy-based vascular sealing and cutting instruments: A porcine model</atitle><jtitle>Surgical endoscopy</jtitle><stitle>Surg Endosc</stitle><addtitle>Surg Endosc</addtitle><date>2008-02-01</date><risdate>2008</risdate><volume>22</volume><issue>2</issue><spage>534</spage><epage>538</epage><pages>534-538</pages><issn>0930-2794</issn><eissn>1432-2218</eissn><coden>SUREEX</coden><abstract>Aim To compare the safety and efficacy of four energy-based vascular sealing and cutting instruments. Methods Blood vessels of various types and diameters were harvested from four pigs using four instruments: Harmonic ACE™ (Ethicon Endo-Surgery, Cincinnati, OH), LigaSure™ V and LigaSure Atlas™ (Valleylab, Inc., Boulder, CO; a division of Tyco Healthcare), and EnSeal™ vessel fusion system (SurgRx, Inc. Redwood City, CA). The diameters of the vessels, speed and adequacy of the cutting and sealing process, and bursting pressures were compared. An additional set of specimens was sealed and left in situ for up to 4 h after which the vessels were harvested and histopathologically analyzed for the degree of thermal injury. Results The bursting pressures were significantly higher with EnSeal™ compared to all other instruments ( p &lt; 0.0001). The sealing process was significantly shorter with Harmonic ACE™ and significantly longer with LigaSure Atlas™ ( p &lt;0.0001). The mean seal width was larger with the LigaSure Atlas™ compared to the other instruments, and it was smaller with EnSeal™ and Harmonic ACE™. Less radial adventitial collagen denaturation was present with EnSeal™ and LigaSure™ V than with the other two instruments; there were no significant differences in collagen denaturation although proximal thermal injury to the smooth muscle in the media of the vessel wall was less common with LigaSure Atlas™ than with the other instruments; however, the numbers were too small for statistical analysis. Conclusions The bursting pressures with EnSeal™ were significantly higher than with all the other instruments. Harmonic ACE™ was the fastest sealing instrument and LigaSure Atlas™ was slowest. EnSeal™ created less radial thermal damage to the adventitial collagen of the vessels and LigaSure Atlas™ created less thermal damage to the media of the vessels. The clinical significance of these findings is unknown.</abstract><cop>New York</cop><pub>Springer-Verlag</pub><pmid>18097720</pmid><doi>10.1007/s00464-007-9619-8</doi><tpages>5</tpages></addata></record>
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source MEDLINE; SpringerLink Journals - AutoHoldings
subjects Abdominal Surgery
Animals
Biological and medical sciences
Blood Vessels - pathology
Electricity
Equipment Design
Gastroenterology
General aspects
Gynecology
Hepatology
Medical sciences
Medicine
Medicine & Public Health
Models, Animal
Pressure
Proctology
Surgery
Swine
Vascular Surgical Procedures - instrumentation
title Comparison of four energy-based vascular sealing and cutting instruments: A porcine model
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