• Surgical endoscopy · Feb 2018

    Comparative Study

    Implementation of a novel efficacy score to compare sealing and cutting devices in a porcine model.

    • Lea Brecht, Markus Wallwiener, Sarah Schott, Christoph Domschke, Christine Dinkic, Michael Golatta, Florian Schuetz, Herbert Fluhr, Albrecht Stenzinger, Marietta Kirchner, Christof Sohn, and Joachim Rom.
    • Department for Internal Medicine, St. Josef's Hospital, Heidelberg, Germany.
    • Surg Endosc. 2018 Feb 1; 32 (2): 1002-1011.

    BackgroundIn general surgery, minimally invasive laparoscopic procedures have been steadily increasing over the last decade. The application of advanced bipolar and ultrasonic energy devices for sealing and cutting of blood vessels plays a vital role in routine clinical procedures. The advantages of energy-based instruments are enhanced sealing capability combined with both fast sealing time and minimal thermal injury. The purpose of this study was to compare the safety and efficacy profiles of nine laparoscopic sealing and cutting devices in a porcine model, with a new scoring system.MethodsComparative studies in a porcine model were performed to assess vessel sealing, burst pressure, thermal spread, maximum heat, sealing/cooling time, and compression strength over the full jaw. Nine different devices from five manufacturers were tested in this study. The sealing and cutting devices (SCD) score has been developed to enable standardized comparisons of various devices. For this purpose, the most important parameters were identified through a consensus approach.ResultsAll sealed vessels with different devices could withstand a median pressure of more than 300 mmHg (range 112-2046 mmHg). The time for the sealing procedure was 7.705 s (range 5.305-18.38 s) for the ultrasonic and 7.860 s (range 5.08-10.17 s) for the bipolar devices. The ultrasonic instruments reached a median temperature of 218.1 °C (range 81.3-349.75 °C) and the bipolar devices a temperature of 125.5 °C (range 94.1-133.35 °C). The tissue reached a median temperature of 61.9 (range 47.1-80.6 °C) after ultrasonic sealing and 76.7 °C (range 63.1-94.2 °C) after bipolar sealing. The median SCD score was 10.47 (range 7.16-13.72).ConclusionAll the instruments used seemed safe for use on the patient. The SCD score allows an indirect comparability of the instruments.

      Pubmed     Full text   Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…