• Paul K Pietrow, Alon Z Weizer, James O L'Esperance, Brian K Auge, Ari Silverstein, Thomas Cummings, Glenn M Preminger, and David M Albala.
• Department of Urology, Duke University Medical Center, Durham, North Carolina 27710, USA.
• J. Endourol. 2005 Jan 1;19(1):107-10.

Background And PurposeLaparoscopic bipolar instruments are commonly employed to cauterize and divide tissue. A next-generation bipolar device has been developed that employs vapor pulse coagulation energy. We assessed the vessel-sealing capability of this device and quantified thermal spread during application.Materials And MethodsBilateral laparoscopic nephrectomy was performed on six common swine >25 kg. Five-millimeter clips and surgical staplers (US Surgical, Norwalk, CT) were utilized to perform nephrectomy on one side, while the Gyrus PlasmaKinetic bipolar device (Minneapolis, MN) was employed for the contralateral nephrectomy. Vessel-sealing capabilities were assessed via burst-pressure studies. The extent of thermal spread was measured after tissue fixation and hematoxylin and eosin staining.ResultsSurgical clips/vascular staplers adequately controlled/sealed renal hilar vessels with burst pressures nearing 300 mm Hg. The Gyrus bipolar device reliably sealed and divided renal arteries ConclusionsThe Gyrus PlasmaKinetic bipolar device is capable of reliably sealing/ dividing arteries as large as 6 mm, although we recommend restricting its use to vessels no larger than 5 mm in diameter to allow a safety margin. In addition, porcine renal veins of all sizes are adequately controlled. These sealed vessels are able to withstand pressures approaching 300 mm Hg. Thermal spread affects only the area surrounding the divided vessel. Further clinical studies are warranted.

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