Postoperative efficacy and safety of vessel sealing: an experimental study on carotid arteries of the pig

Berdah, Stéphane; Hoff, Christiaan; Poornoroozy, Peiman; Razek, Peter; Nieuwenhove, Yves Van

doi:10.1007/s00464-012-2177-8

Cited by 5 publications

(3 citation statements)

References 22 publications

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“…Burst pressure testing is an important outcome measure because it simulates the mechanism for failure during surgery . Multiple evaluations of different EBVS have been performed to assess the seal strength quantitated through burst pressure in in vivo or ex vivo animal models. Advantages of ex vivo study protocols include reduced use of animals, allowance for more stringent experimental set up, and that they may be conducted with a larger sample of tissue that is readily available in terms of cost and ethical considerations .…”

Section: Discussionmentioning

confidence: 99%

“…The use of electrothermal bipolar vessel sealing devices (EBVS) in minimally invasive surgery (MIS) allows for efficient hemostasis without persistent foreign material, decreased tissue manipulation, improved operative safety, and reduced surgical and anesthesia time. Some EBVS handpieces are also designed to allow blunt tissue dissection prior to activation of energy to avoid repeated instrument exchanges during MIS …”

Section: Introductionmentioning

confidence: 99%

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Evaluation of the performance of an endoscopic 3‐mm electrothermal bipolar vessel sealing device intended for single use after multiple use‐and‐resterilization cycles

et al. 2020

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Objective To evaluate the performance of an endoscopic 3‐mm electrothermal bipolar vessel sealing device (EBVS) intended for single use after multiple use‐and‐resterilization cycles. Study design Ex vivo study. Sample population Eight 3‐mm EBVS handpieces. Methods Handpieces were subjected to a maximum of 15 cycles of testing, including simulated surgery, sealing and burst pressure testing of porcine carotid arteries, reprocessing, and hydrogen peroxide plasma resterilization. Failure was defined as two sequential vascular seal leakage events occurring at <250 mm Hg. Histological evaluation, maximum external temperature of the jaws, sealing time, tissue adherence, jaw surface characterization, and mechanical deterioration were studied. Failure rate was analyzed by using a Kaplan–Meier curve. Linear and ordinal logistic mixed models were used to analyze sealing time, handpiece jaw temperature, and adherence score. Results Mean ± SD diameter of arteries was 3.22 ± 0.35 mm. Failure was observed starting at cycle 10 and going up to cycle 13 in 37.5% (3/8) of the handpieces. Tissue adherence increased after each cycle (P < .001). Maximum external temperature (79.8°C ± 13.9°C) and sealing time (1.8 ± 0.5 seconds) were not significantly different throughout cycles up to failure. A flatter surface and large scratches were observed microscopically throughout the jaw surface after repeated use and resterilization. Conclusion The 3‐mm EBVS handpiece evaluated in this study can be considered safe to use for up to nine reuse‐and‐resterilization cycles. Clinical significance These data provide the basis for establishing preliminary guidelines for the reuse and hydrogen peroxide plasma resterilization of an endoscopic 3‐mm EBVS handpiece.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Evaluation of the performance of an endoscopic 3‐mm electrothermal bipolar vessel sealing device intended for single use after multiple use‐and‐resterilization cycles

et al. 2020

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“…Published values strongly vary from 50 mmHg [19], 150 mmHg [8], 250 mmHg [14], 300 mmHg [20-22], 360 mmHg [23], up to 400 mmHg [24]. Nevertheless, burst pressure provides a reproducible stability index of the seal.…”

Section: Methodsunclassified

Rationale, bench testing and in vivo evaluation of a novel 5 mm laparoscopic vessel sealing device with homogeneous pressure distribution in long instrument jaws

Eick¹,

Loudermilk²,

Walberg³

et al. 2013

Ann Surg Innov Res

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BackgroundIn 1998, an electrothermal bipolar vessel sealing (EBVS) system was introduced and quickly became an integral component of the surgical armamentarium in various surgical specialties. Currently available EBVS instruments use a scissor-like jaw configuration and closing mechanism, which causes decreasing compression pressure from the proximal to the distal end of the jaws. A new EBVS system is described here which utilizes a different instrument jaw configuration and closing mechanism to enable a more homogeneous pressure distribution despite longer instrument jaws.MethodsResults of jaw pressure distribution measurements as well as sealing experiments with subsequent burst pressure measurements ex vivo on bovine uterine arteries are demonstrated. Furthermore, an in vivo evaluation of the new EBVS system in a canine and porcine model including histological examination is presented.ResultsThe device revealed an even pressure distribution throughout the whole jaw length. The ex vivo burst pressure measurements revealed high average burst pressures, above 300 mmHg, independent of the outer diameter (1 to 7 mm) of the tested vessels. Histological evaluation of sealed vessels 21 days postoperatively demonstrated sealed and fused vessels without adjacent tissue damage.ConclusionsThe even pressure distribution leading to a sufficient tissue sealing in combination with the novel closing mechanism and extended jaw length differentiates the novel device from other available EBVS systems. This might offer a reduction of the overall procedure time, which should be further evaluated in a clinical study.

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Surface-processing technology of a microgrooving and water-repellent coating improves the fusion potential of an ultrasonic energy device

et al. 2016

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Postoperative efficacy and safety of vessel sealing: an experimental study on carotid arteries of the pig

Abstract: Postoperative variations are observed in the burst pressure of in vivo sealed arteries. Immediate burst pressure alone should not be used for validating vascular sealing devices.

Cited by 5 publications

References 22 publications

Evaluation of the performance of an endoscopic 3‐mm electrothermal bipolar vessel sealing device intended for single use after multiple use‐and‐resterilization cycles

Evaluation of the performance of an endoscopic 3‐mm electrothermal bipolar vessel sealing device intended for single use after multiple use‐and‐resterilization cycles

Rationale, bench testing and in vivo evaluation of a novel 5 mm laparoscopic vessel sealing device with homogeneous pressure distribution in long instrument jaws

Surface-processing technology of a microgrooving and water-repellent coating improves the fusion potential of an ultrasonic energy device

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