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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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 |
format | Article |
fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_70278845</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>70278845</sourcerecordid><originalsourceid>FETCH-LOGICAL-c465t-344e27ce2fc322c75d9728e55411d7143b4abb98072ef94b4e0f216c95ccd3f93</originalsourceid><addsrcrecordid>eNp1kEFr3DAQhUVpaDZpf0AvRRSSmxJpLFtWbmFpk0Cgl-bQk5Dl0eJgS1vJDuTfR9tdGgjkNA_mm5k3j5Cvgl8IztVl5lw2khXJdCM0az-QlZAVMADRfiQrrivOQGl5TE5yfuQF16L-RI5Fy7VSwFfkzzpOW5uGHAONnvq4JIoB0-aZdTZjT59sdstoE81oxyFsqA09dcs87_QQ8pyWCcOcr-g13cbkhoB0ij2On8mRt2PGL4d6Sh5-_vi9vmX3v27u1tf3zMmmnlklJYJyCN5VAE7VvVbQYl1LIXpVvumk7TrdcgXotewkcg-icbp2rq-8rk7J-X7vNsW_C-bZTEN2OI42YFyyURxU28q6gN_fgI_l21C8GRC6BgmNKpDYQy7FnBN6s03DZNOzEdzsQjf70M1O7kI3bZn5dli8dBP2rxOHlAtwdgBKmHb0yQY35P8ccFFp_c8h7LlcWmGD6dXh-9dfAEMgmTI</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>219524267</pqid></control><display><type>article</type><title>Comparison of four energy-based vascular sealing and cutting instruments: A porcine model</title><source>MEDLINE</source><source>SpringerLink Journals - AutoHoldings</source><creator>Person, Benjamin ; Vivas, David A. ; Ruiz, Dan ; Talcott, Michael ; Coad, James E. ; Wexner, Steven D.</creator><creatorcontrib>Person, Benjamin ; Vivas, David A. ; Ruiz, Dan ; Talcott, Michael ; Coad, James E. ; Wexner, Steven D.</creatorcontrib><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
<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 & 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&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
< 0.0001). The sealing process was significantly shorter with Harmonic ACE™ and significantly longer with LigaSure Atlas™ (
p
<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><subject>Abdominal Surgery</subject><subject>Animals</subject><subject>Biological and medical sciences</subject><subject>Blood Vessels - pathology</subject><subject>Electricity</subject><subject>Equipment Design</subject><subject>Gastroenterology</subject><subject>General aspects</subject><subject>Gynecology</subject><subject>Hepatology</subject><subject>Medical sciences</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Models, Animal</subject><subject>Pressure</subject><subject>Proctology</subject><subject>Surgery</subject><subject>Swine</subject><subject>Vascular Surgical Procedures - instrumentation</subject><issn>0930-2794</issn><issn>1432-2218</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2008</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp1kEFr3DAQhUVpaDZpf0AvRRSSmxJpLFtWbmFpk0Cgl-bQk5Dl0eJgS1vJDuTfR9tdGgjkNA_mm5k3j5Cvgl8IztVl5lw2khXJdCM0az-QlZAVMADRfiQrrivOQGl5TE5yfuQF16L-RI5Fy7VSwFfkzzpOW5uGHAONnvq4JIoB0-aZdTZjT59sdstoE81oxyFsqA09dcs87_QQ8pyWCcOcr-g13cbkhoB0ij2On8mRt2PGL4d6Sh5-_vi9vmX3v27u1tf3zMmmnlklJYJyCN5VAE7VvVbQYl1LIXpVvumk7TrdcgXotewkcg-icbp2rq-8rk7J-X7vNsW_C-bZTEN2OI42YFyyURxU28q6gN_fgI_l21C8GRC6BgmNKpDYQy7FnBN6s03DZNOzEdzsQjf70M1O7kI3bZn5dli8dBP2rxOHlAtwdgBKmHb0yQY35P8ccFFp_c8h7LlcWmGD6dXh-9dfAEMgmTI</recordid><startdate>20080201</startdate><enddate>20080201</enddate><creator>Person, Benjamin</creator><creator>Vivas, David A.</creator><creator>Ruiz, Dan</creator><creator>Talcott, Michael</creator><creator>Coad, James E.</creator><creator>Wexner, Steven D.</creator><general>Springer-Verlag</general><general>Springer</general><general>Springer Nature B.V</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20080201</creationdate><title>Comparison of four energy-based vascular sealing and cutting instruments: A porcine model</title><author>Person, Benjamin ; 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 & 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 & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & 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
< 0.0001). The sealing process was significantly shorter with Harmonic ACE™ and significantly longer with LigaSure Atlas™ (
p
<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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