Tissue effects in vessel sealing and transection from an ultrasonic device with more intelligent control of energy delivery

Duan Broughton,1 Alissa L Welling,1 Emily H Monroe,1 Kristen Pirozzi,2 John B Schulte,1 Jeffrey W Clymer1 1Ethicon Endo-Surgery, Inc., Cincinnati, OH, 2University of Central Florida, Orlando, FL, USA Background: Ultrasonic surgical devices have been demonstrated to provide excellent hemostasis, effi...

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Autores principales:	Broughton D, Welling AL, Monroe EH, Pirozzi K, Schulte JB, Clymer JW
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2013
Materias:	Medical technology R855-855.5
Acceso en línea:	https://doaj.org/article/e2692bc6f7294b758d6d33e1781c9393
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spelling	oai:doaj.org-article:e2692bc6f7294b758d6d33e1781c93932021-12-02T02:43:52ZTissue effects in vessel sealing and transection from an ultrasonic device with more intelligent control of energy delivery1179-1470https://doaj.org/article/e2692bc6f7294b758d6d33e1781c93932013-09-01T00:00:00Zhttp://www.dovepress.com/tissue-effects-in-vessel-sealing-and-transection-from-an-ultrasonic-de-a14368https://doaj.org/toc/1179-1470Duan Broughton,1 Alissa L Welling,1 Emily H Monroe,1 Kristen Pirozzi,2 John B Schulte,1 Jeffrey W Clymer1 1Ethicon Endo-Surgery, Inc., Cincinnati, OH, 2University of Central Florida, Orlando, FL, USA Background: Ultrasonic surgical devices have been demonstrated to provide excellent hemostasis, efficient transection, minimal lateral thermal damage, low smoke generation, and no risk of electrical current passage to the patient. These benefits originate from the inherent characteristics of the ultrasonic mechanism, but further improvements were thought possible through optimization of the energy delivery during application. The study reported here compared a new ultrasonic device, Harmonic ACE®+ Shears with Adaptive Tissue Technology, with a commercial predicate device, Harmonic ACE® Shears (both Ethicon Endo-Surgery, Inc., Cincinnati, OH, USA). Methods: Devices were evaluated in an in vivo porcine model intraoperatively and after a 30-day survival period. Both devices were used to seal a variety of vessels 1–5 mm in diameter, and compared for hemostasis, histological thermal damage, and adhesion formation. Sealed vessels were evaluated ex vivo for burst pressure, and visual obstruction caused by plumage from device application was assessed quantitatively. Results: ACE+ produced significantly less thermal damage, had fewer adhesions, offered faster transection, involved less visual obstruction, and had higher burst pressures than the predicate device. All vessel seals, evaluated over the course of a 30-day survival period in pigs, remained intact. Conclusion: The new Adaptive Tissue Technology algorithm assists the surgeon in achieving better control of energy delivery to the tissue, sealing vessels with supra-physiological burst pressures, and low thermal damage. These preclinical results with Harmonic ACE+ may translate into meaningful clinical benefits, providing greater precision along with more efficient and effective cutting and coagulation in open or laparoscopic procedures. Keywords: ultrasonic, Harmonic, ACE, vessel sealing, burst pressure, adhesions, Adaptive Tissue TechnologyBroughton DWelling ALMonroe EHPirozzi KSchulte JBClymer JWDove Medical PressarticleMedical technologyR855-855.5ENMedical Devices: Evidence and Research, Vol 2013, Iss default, Pp 151-154 (2013)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medical technology R855-855.5
spellingShingle	Medical technology R855-855.5 Broughton D Welling AL Monroe EH Pirozzi K Schulte JB Clymer JW Tissue effects in vessel sealing and transection from an ultrasonic device with more intelligent control of energy delivery
description	Duan Broughton,1 Alissa L Welling,1 Emily H Monroe,1 Kristen Pirozzi,2 John B Schulte,1 Jeffrey W Clymer1 1Ethicon Endo-Surgery, Inc., Cincinnati, OH, 2University of Central Florida, Orlando, FL, USA Background: Ultrasonic surgical devices have been demonstrated to provide excellent hemostasis, efficient transection, minimal lateral thermal damage, low smoke generation, and no risk of electrical current passage to the patient. These benefits originate from the inherent characteristics of the ultrasonic mechanism, but further improvements were thought possible through optimization of the energy delivery during application. The study reported here compared a new ultrasonic device, Harmonic ACE®+ Shears with Adaptive Tissue Technology, with a commercial predicate device, Harmonic ACE® Shears (both Ethicon Endo-Surgery, Inc., Cincinnati, OH, USA). Methods: Devices were evaluated in an in vivo porcine model intraoperatively and after a 30-day survival period. Both devices were used to seal a variety of vessels 1–5 mm in diameter, and compared for hemostasis, histological thermal damage, and adhesion formation. Sealed vessels were evaluated ex vivo for burst pressure, and visual obstruction caused by plumage from device application was assessed quantitatively. Results: ACE+ produced significantly less thermal damage, had fewer adhesions, offered faster transection, involved less visual obstruction, and had higher burst pressures than the predicate device. All vessel seals, evaluated over the course of a 30-day survival period in pigs, remained intact. Conclusion: The new Adaptive Tissue Technology algorithm assists the surgeon in achieving better control of energy delivery to the tissue, sealing vessels with supra-physiological burst pressures, and low thermal damage. These preclinical results with Harmonic ACE+ may translate into meaningful clinical benefits, providing greater precision along with more efficient and effective cutting and coagulation in open or laparoscopic procedures. Keywords: ultrasonic, Harmonic, ACE, vessel sealing, burst pressure, adhesions, Adaptive Tissue Technology
format	article
author	Broughton D Welling AL Monroe EH Pirozzi K Schulte JB Clymer JW
author_facet	Broughton D Welling AL Monroe EH Pirozzi K Schulte JB Clymer JW
author_sort	Broughton D
title	Tissue effects in vessel sealing and transection from an ultrasonic device with more intelligent control of energy delivery
title_short	Tissue effects in vessel sealing and transection from an ultrasonic device with more intelligent control of energy delivery
title_full	Tissue effects in vessel sealing and transection from an ultrasonic device with more intelligent control of energy delivery
title_fullStr	Tissue effects in vessel sealing and transection from an ultrasonic device with more intelligent control of energy delivery
title_full_unstemmed	Tissue effects in vessel sealing and transection from an ultrasonic device with more intelligent control of energy delivery
title_sort	tissue effects in vessel sealing and transection from an ultrasonic device with more intelligent control of energy delivery
publisher	Dove Medical Press
publishDate	2013
url	https://doaj.org/article/e2692bc6f7294b758d6d33e1781c9393
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Tissue effects in vessel sealing and transection from an ultrasonic device with more intelligent control of energy delivery

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