Clinical Use of a Cordless Laparoscopic Ultrasonic Device

Abstract

Objective:On April 25, 2012, the first laparoscopic cordless ultrasonic device (Sonicision, Covidien, Mansfield, Massachusetts) was used in a clinical setting. We describe our initial experience.Methods:The cordless device is assembled with a reusable battery and generator on a base hand-piece. It has a minimum and maximum power setting controlled by a single trigger for both coagulation and cutting. A laparoscopic radical nephrectomy was performed on a 56-year-old man with a 7-cm right renal mass. A laparoscopic pelvic lymphadenectomy was performed in a 51-year-old man with high-risk prostate cancer. Data on surgical team satisfaction, operative time, number of activations, and times the laparoscope was removed as a result of plume were collected.Results:The surgical technician successfully assembled the device at the beginning of the cases with verbal instructions from the surgeon. Operative time for nephrectomy was 77 minutes, with 143 total activations (minimum = 86, maximum = 57). The operative time for the pelvic lymphadenectomy was 27 minutes, with 38 total activations (minimum = 27, maximum = 11). One battery was used in each case. The laparoscope was removed twice during the nephrectomy and once during the lymphadenectomy. Surgical staff satisfaction survey results revealed easier and faster assembly, more space in the operating room, ergonomic handle, and comparable cutting/coagulation, weight, and plume generation with other devices (Table 1).Table 1.Survey of Operating Room StaffaEasy/YesDifficult/NoAbility to assemble the device7 (100%)0Ability to hand the device over to other members of the surgical team7 (100%)0Efficiency in saving space in the operating room7 (100%)0Overall satisfactionUnsatisfactoryIndifferentSatisfactory007 (100%)aOperating staff consisted of 4 surgeons and 3 scrub technicians and/or registered nurses.Conclusion:The first clinical application of the pioneering cordless dissector was successfully performed, resulting in surgeons' perceptions of comparable results with other devices of easier and safer use and faster assembly.

Cordless ultrasonic dissector versus advanced bipolar vessel sealing device for laparoscopic ovariectomy in dogs*

“…The SCUD had significantly decreased surgical smoke production compared to Harmonic ACE in ex vivo studies . Clinically, SCUD was successfully applied in a laparoscopic nephrectomy and a lymphadenectomy procedure in people . No data are available on the use of SCUD in dogs.…”

“…22,23 Clinically, SCUD was successfully applied in a laparoscopic nephrectomy and a lymphadenectomy procedure in people. 24 No data are available on the use of SCUD in dogs.…”

Laparoscopic ultrasonic dissectors: technology update by a review of literature

“…During coagulation, the ACE generates five times more smoke than SNC, whereas SS creates the lower amounts 10. According to the area, SS smoke covers 0.21% of the operating field, whereas SNC covers 4.8% of the field and ACE covers 26.63% of the field 13. The SNC produces up to five times less surgical plume than TB, despite the latter has a higher flexibility with speedier cutting speed, comparable bursting pressure and worthy spread 14.…”

“…In addition, the intuitive dual-mode energy activation control offers minimum and maximum power modes within one button, allowing easy transition between energy modes, rapid tissue dissection and safe hemostasis. The reusable handheld generator works with a reusable battery; therefore, it is not required to connect the device to a bulky generator outside the surgical field 13…”

Postmarketing Analysis of a Novel, Cordless Ultrasonic Dissector

“…1 This prototype has been translated to a clinical model that is currently on the market and has been successfully used in the operating room for vessel sealing and tissue dissection. Kim and colleagues 2 have published the first report regarding use of the cordless ultrasonic dissector to successfully complete a laparoscopic nephrectomy and pelvic lymphadenectomy. A follow-up published product review from Dr J. Greenberg 3 describes excellent product performance in laparoscopic gynecologic surgery.…”