Current status on the adoption of high energy devices in Italy: An Italian Society for Endoscopic Surgery and New Techno
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and Other Interventional Techniques
Current status on the adoption of high energy devices in Italy: An Italian Society for Endoscopic Surgery and New Technologies (SICE) national survey Emanuele Botteri1 · Mauro Podda2 · Alberto Arezzo3 · Nereo Vettoretto1 · Alberto Sartori4 · Antonino Agrusa5 · Marco Ettore Allaix3 · Gabriele Anania6 · Riccardo Brachet Contul7 · Valerio Caracino8 · Elisa Cassinotti9 · Diego Cuccurullo10 · Giancarlo D’Ambrosio11 · Marco Milone12 · Irnerio Muttillo13 · Wanda Luisa Petz14 · Marcello Pisano15 · Mario Guerrieri16 · Gianfranco Silecchia17 · Ferdinando Agresta18 Received: 22 July 2020 / Accepted: 21 October 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Background In the past three decades, different High Energy Devices (HED) have been introduced in surgical practice to improve the efficiency of surgical procedures. HED allow vessel sealing, coagulation and transection as well as an efficient tissue dissection. This survey was designed to verify the current status on the adoption of HED in Italy. Methods A survey was conducted across Italian general surgery units. The questionnaire was composed of three sections (general information, elective surgery, emergency surgery) including 44 questions. Only one member per each surgery unit was allowed to complete the questionnaire. For elective procedures, the survey included questions on thyroid surgery, lower and upper GI surgery, proctologic surgery, adrenal gland surgery, pancreatic and hepatobiliary surgery, cholecystectomy, abdominal wall surgery and breast surgery. Appendectomy, cholecystectomy for acute cholecystitis and bowel obstruction due to adhesions were considered for emergency surgery. The list of alternatives for every single question included a percentage category as follows: “ 75%”, both for open and minimally-invasive surgery. Results A total of 113 surgical units completed the questionnaire. The reported use of HED was high both in open and minimally-invasive upper and lower GI surgery. Similarly, HED were widely used in minimally-invasive pancreatic and adrenal surgery. The use of HED was wider in minimally-invasive hepatic and biliary tree surgery compared to open surgery, whereas the majority of the respondents reported the use of any type of HED in less than 25% of elective cholecystectomies. HED were only rarely employed also in the majority of emergency open and laparoscopic procedures, including cholecystectomy, appendectomy, and adhesiolysis. Similarly, very few respondents declared to use HED in abdominal wall surgery and proctology. The distribution of the most used type of HED varied among the different surgical interventions. US HED were mostly used in thyroid, upper GI, and adrenal surgery. A relevant use of H-US/RF devices was reported in lower GI, pancreatic, hepatobiliary and breast surgery. RF HED were the preferred choice in proctology. Conclusion HED are extensively used in minimally-invasive elective surgery involving the upper and lower GI tract, liver, pancreas
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