A new method using a vessel-sealing system provides coagulation effects to various types of bleeding with less thermal d
- PDF / 6,417,961 Bytes
- 12 Pages / 595.276 x 790.866 pts Page_size
- 23 Downloads / 143 Views
and Other Interventional Techniques
DYNAMIC MANUSCRIPT
A new method using a vessel‑sealing system provides coagulation effects to various types of bleeding with less thermal damage Shosaburo Oyama1,2 · Takashi Nonaka1 · Keitaro Matsumoto1,2 · Daisuke Taniguchi1,2 · Yasumasa Hashimoto1,2 · Tomohiro Obata1,2 · Makoto Hisanaga1,2 · Masaaki Moriyama1,2 · Naoto Matsuo1,2 · Hideo Wada1 · Kiyoaki Hamada1 · Kouki Wakata1 · Tetsuro Tominaga1 · Shigekazu Hidaka1,2 · Terumitsu Sawai1 · Takeshi Nagayasu1,2 Received: 13 December 2019 / Accepted: 22 September 2020 © The Author(s) 2020
Abstract Background Hemostasis is very important for a safe surgery, particularly in endoscopic surgery. Accordingly, in the last decade, vessel-sealing systems became popular as hemostatic devices. However, their use is limited due to thermal damage to organs, such as intestines and nerves. We developed a new method for safe coagulation using a vessel-sealing system, termed flat coagulation (FC). This study aimed to evaluate the efficacy of this new FC method compared to conventional coagulation methods. Methods We evaluated the thermal damage caused by various energy devices, such as the vessel-sealing system (FC method using LigaSure™), ultrasonic scissors (Sonicision™), and monopolar electrosurgery (cut/coagulation/spray/soft coagulation (SC) mode), on porcine organs, including the small intestine and liver. Furthermore, we compared the hemostasis time between the FC method and conventional methods in the superficial bleeding model using porcine mesentery. Results FC caused less thermal damage than monopolar electrosurgery’s SC mode in the porcine liver and small intestine (liver: mean depth of thermal damage, 1.91 ± 0.35 vs 3.37 ± 0.28 mm; p = 0.0015). In the superficial bleeding model, the hemostasis time of FC was significantly shorter than that of electrosurgery’s SC mode (mean, 19.54 ± 22.51 s vs 44.99 ± 21.18 s; p = 0.0046). Conclusion This study showed that the FC method caused less thermal damage to porcine small intestine and liver than conventional methods. This FC method could provide easier and faster coagulation of superficial bleeds compared to that achieved by electrosurgery’s SC mode. Therefore, this study motivates for the use of this new method to achieve hemostasis with various types of bleeds involving internal organs during endoscopic surgeries. Keywords Flat coagulation · Laparoscopic surgery · Thermal damage · Vessel-sealing system The progress of endoscopic surgery in recent years has been remarkable. Among other reasons, this is due to the development of surgical equipment, particularly, hemostatic devices. Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00464-020-08043-z) contains supplementary material, which is available to authorized users. * Takeshi Nagayasu nagayasu@nagasaki‑u.ac.jp 1
Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Sciences, 1‑7‑1 Sakamoto, Nagasaki 852‑8501, Japan
Medical‑Engineering Hybrid Profe
Data Loading...
