Laparoscopic ultrasonic dissectors: technology update by a review of literature

Rajesh Devassy,1 Sadaf Hanif,1 Harald Krentel,2 Hugo C Verhoeven,2 Luz Angela Torres-de la Roche,2 Rudy Leon De Wilde2 1Dubai London Clinic & Specialty Hospital, Dubai, UAE; 2Clinic of Gynecology, Obstetrics and Gynecological Oncology, University Hospital for Gynecology, Carl von Ossietzky U...

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Autores principales:	Devassy R, Hanif S, Krentel H, Verhoeven HC, Torres-de la Roche LA, De Wilde RL
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2018
Materias:	Laparoscopy Ultrasonic dissectors Thermal damage Energy devices Medical technology R855-855.5
Acceso en línea:	https://doaj.org/article/48769f3aec67413fb40ff63125626305
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spelling	oai:doaj.org-article:48769f3aec67413fb40ff631256263052021-12-02T02:53:04ZLaparoscopic ultrasonic dissectors: technology update by a review of literature1179-1470https://doaj.org/article/48769f3aec67413fb40ff631256263052018-12-01T00:00:00Zhttps://www.dovepress.com/laparoscopic-ultrasonic-dissectors-technology-update-by-a-review-of-li-peer-reviewed-article-MDERhttps://doaj.org/toc/1179-1470Rajesh Devassy,1 Sadaf Hanif,1 Harald Krentel,2 Hugo C Verhoeven,2 Luz Angela Torres-de la Roche,2 Rudy Leon De Wilde2 1Dubai London Clinic & Specialty Hospital, Dubai, UAE; 2Clinic of Gynecology, Obstetrics and Gynecological Oncology, University Hospital for Gynecology, Carl von Ossietzky University, Pius-Hospital Oldenburg, Oldenburg, Germany Abstract: The evolution of minimally invasive surgery has brought forward the appearance of new advances in the course of the most recent couple of years and has introduced energy-based devices. The newest among them today are the ultrasonically activated devices, which are utilized with a great deal of components in-play, including ergonomics and financial aspects amid surgery. The methodology embraced was finding significant investigations through studies from PubMed, Medline and Google Scholar on current ultrasonic dissectors, which are Ethicon’s Harmonic Scalpel (ACE®), Covidien’s Sonicision™ (SNC), Conmed’s SonoSurg® (SS) and Olympus’s Thunderbeat®, to describe their efficacy in terms of vessel sealing speed, vessel burst pressure, visibility, operation time and thermal speed. We found postmarketing evidence to determine which device exhibits the better performance. Animal studies showed that emissivity values and maximum temperatures for coagulation are similar among devices but maximum cutting temperatures are significantly different: ACE = 191.1°C, SNC = 227.1°C, SS = 184.8°C (p < 0.001). Cooling times are significantly different among devices: 35.7 s for ACE, 38.7 s for SNC and 27.4 s for SS (p < 0.001). Cooling times of passive jaws to reach 60°C after activation were also significantly different: 25.4 s for ACE, 5.7 s for SNC, and 15.4 s for SS (p < 0.001). The perfect device would unify brilliant hemostatic outcomes with visual sharpness while permitting none or insignificant thermal damage at the place of use. Keywords: laparoscopy, ultrasonic dissectors, thermal damage, energy devicesDevassy RHanif SKrentel HVerhoeven HCTorres-de la Roche LADe Wilde RLDove Medical PressarticleLaparoscopyUltrasonic dissectorsThermal damageEnergy devicesMedical technologyR855-855.5ENMedical Devices: Evidence and Research, Vol Volume 12, Pp 1-7 (2018)
institution	DOAJ
collection	DOAJ
language	EN
topic	Laparoscopy Ultrasonic dissectors Thermal damage Energy devices Medical technology R855-855.5
spellingShingle	Laparoscopy Ultrasonic dissectors Thermal damage Energy devices Medical technology R855-855.5 Devassy R Hanif S Krentel H Verhoeven HC Torres-de la Roche LA De Wilde RL Laparoscopic ultrasonic dissectors: technology update by a review of literature
description	Rajesh Devassy,1 Sadaf Hanif,1 Harald Krentel,2 Hugo C Verhoeven,2 Luz Angela Torres-de la Roche,2 Rudy Leon De Wilde2 1Dubai London Clinic & Specialty Hospital, Dubai, UAE; 2Clinic of Gynecology, Obstetrics and Gynecological Oncology, University Hospital for Gynecology, Carl von Ossietzky University, Pius-Hospital Oldenburg, Oldenburg, Germany Abstract: The evolution of minimally invasive surgery has brought forward the appearance of new advances in the course of the most recent couple of years and has introduced energy-based devices. The newest among them today are the ultrasonically activated devices, which are utilized with a great deal of components in-play, including ergonomics and financial aspects amid surgery. The methodology embraced was finding significant investigations through studies from PubMed, Medline and Google Scholar on current ultrasonic dissectors, which are Ethicon’s Harmonic Scalpel (ACE®), Covidien’s Sonicision™ (SNC), Conmed’s SonoSurg® (SS) and Olympus’s Thunderbeat®, to describe their efficacy in terms of vessel sealing speed, vessel burst pressure, visibility, operation time and thermal speed. We found postmarketing evidence to determine which device exhibits the better performance. Animal studies showed that emissivity values and maximum temperatures for coagulation are similar among devices but maximum cutting temperatures are significantly different: ACE = 191.1°C, SNC = 227.1°C, SS = 184.8°C (p < 0.001). Cooling times are significantly different among devices: 35.7 s for ACE, 38.7 s for SNC and 27.4 s for SS (p < 0.001). Cooling times of passive jaws to reach 60°C after activation were also significantly different: 25.4 s for ACE, 5.7 s for SNC, and 15.4 s for SS (p < 0.001). The perfect device would unify brilliant hemostatic outcomes with visual sharpness while permitting none or insignificant thermal damage at the place of use. Keywords: laparoscopy, ultrasonic dissectors, thermal damage, energy devices
format	article
author	Devassy R Hanif S Krentel H Verhoeven HC Torres-de la Roche LA De Wilde RL
author_facet	Devassy R Hanif S Krentel H Verhoeven HC Torres-de la Roche LA De Wilde RL
author_sort	Devassy R
title	Laparoscopic ultrasonic dissectors: technology update by a review of literature
title_short	Laparoscopic ultrasonic dissectors: technology update by a review of literature
title_full	Laparoscopic ultrasonic dissectors: technology update by a review of literature
title_fullStr	Laparoscopic ultrasonic dissectors: technology update by a review of literature
title_full_unstemmed	Laparoscopic ultrasonic dissectors: technology update by a review of literature
title_sort	laparoscopic ultrasonic dissectors: technology update by a review of literature
publisher	Dove Medical Press
publishDate	2018
url	https://doaj.org/article/48769f3aec67413fb40ff63125626305
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Laparoscopic ultrasonic dissectors: technology update by a review of literature

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