Vessel-Sealing Capability of Novel Microwave Sealer: Experimental Study in Animal Models. (December 2020)

• Record Type: Journal Article
• Authors: Dang, Khiem Tran; Naka, Shigeyuki; Yamada, Atsushi; Mukaisho, Ken-ichi; Tani, Tohru
• Is Part Of: Surgical innovation. Volume 27:Number 6(2020)
• Page Start: 633
• Page End: 643
• Publication Date: 2020-12
• Subjects: electrosurgical device -- microwave sealer -- ultrasonically activated dissectors -- lateral thermal injury; Surgery, Operative -- Periodicals; Endoscopic surgery -- Periodicals; Laparoscopic surgery -- Periodicals; Surgical Procedures, Operative -- Periodicals; Surgical Procedures, Minimally Invasive -- Periodicals; Diffusion of Innovation -- Periodicals; Chirurgie opératoire -- Périodiques; Chirurgie endoscopique -- Périodiques; Chirurgie laparoscopique -- Périodiques; 617.91
• DOI: 10.1177/1553350620937860
• Languages: English
• ISSNs: 1553-3506

Abstract

Background. Ultrasonically activated dissectors (UADs) and radiofrequency-based devices have been considered excellent surgical devices because of their reliability and flexibility. Meanwhile, microwave-based devices have demonstrated potential with their unique heating mechanism. This study aims to compare the sealing function of a newly invented forceps-like microwave sealer (MS) with that of currently available UADs. Materials and Methods. MS and 2 examples of UADs (Harmonic Focus+ [HF+] and Sonicision [SNC]) were employed to perform mesenterectomies (in vivo) and sealing sizable vessels (ex vivo). Vessel diameter, seal time, burst pressure (BP), sealing completion, and instrument sticking were recorded. The samples underwent histological investigation for thermal damage evaluation. Results. During mesenterectomies, MS required 3 seconds and 30 W to secure a complete seal. The BP achieved by the MS seal was higher than that of HF+ and SNC on arteries (851 ± 203.7 vs 682.4 ± 287.3, P < .05; vs 833.1 ± 251.2 mmHg, P = .4523, respectively) but was not statistically different on veins (324.9 ± 203.5 vs 460.1 ± 320.3 vs 508.3 ± 350.7 mmHg, P = .215). In all trials, MS caused less sticking but exhibited similar heat-induced alterations to UADs. MS's thermal spread was not statistically more extended than that of UADs on either arteries or veins. Conclusions. MS was capable of not only sealing tiny vessels but also achieving high-pressure endurance on sizable vessels. Its forceful grasping and synchronous heating process helped create solid stumps with an acceptable thermal spread.