Ultracision Harmonic Scalpel and multifunctional tem400 instrument complement in transanal endoscopic microsurgery: a prospective study

Ayodeji, I. D.; Hop, Wim C. J.; Tetteroo, G. W. M.; Bonjer, H. Jaap; Graaf, Eelco J. R. de

doi:10.1007/s00464-003-9331-2

Cited by 17 publications

(13 citation statements)

References 28 publications

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“…Recently, the harmonic scalpel has been used in transanal endoscopic microsurgery [23][24][25] , endoscopic inguinal and abdominal wall hernia operations [2,26,27] , and hemorrhoidectomy [28] . The harmonic scalpel is used in head and neck surgery [29] and gynecology [30] , except for abdominal surgery.…”

Section: Introductionmentioning

confidence: 99%

How to Prevent Lateral Thermal Damage to Tissue Using the Harmonic Scalpel: Experimental Study on Pig Small Intestine and Abdominal Wall

Pogorelić¹,

Perko²,

Družijanić³

et al. 2009

Eur Surg Res

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Introduction: When using a harmonic scalpel, the lower amount of energy that is transduced to the tissue reduces the chance of lateral thermal damage. Methods: Pigs (weight: 40 kg) were used as the experimental model. After anesthesia, tissue was coagulated using different application regimens for each group. The width of tissue necrosis was measured from the point of incision by the harmonic scalpel. Results: The pig abdominal tissues suffered mean thermal damage of 0.0825 (output power 3) and 0.2969 mm (output power 5) when used for 5 s; at 10 s these values were 0.3850 and 0.4793 mm, respectively. In a third experimental condition, with 10 s of application broken down into 2 parts of 5 s with a 5-second pause in-between, these values were 0.1876 and 0.2013 mm, respectively. The small intestine tissues suffered mean thermal damage of 0.1302 (output power 3) and 0.1771 mm (output power 5) at a duration of 5 s. After 10 s of application, these values changed to 0.2655 (output power 3) and 0.2983 mm (output power 5). In the third condition (activity for 5 s, pause for 5 s, activity for 5 s), they were 0.2011 and 0.2258 mm, respectively. Conclusion: Coagulation necrosis is bigger if the usage is continuous rather than if it is disconnected/reconnected.

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Section: Introductionmentioning

confidence: 99%

How to Prevent Lateral Thermal Damage to Tissue Using the Harmonic Scalpel: Experimental Study on Pig Small Intestine and Abdominal Wall

Pogorelić¹,

Perko²,

Družijanić³

et al. 2009

Eur Surg Res

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“…All of the known risks associated with the application of electric current can be avoided by using ultrasound technology. Clinical studies show a reduction of tissue damage and operative time for ultrasonic dissection compared with monopolar diathermia [8,17].…”

Section: Discussionmentioning

confidence: 99%

“…The curved-shape of the shears enhances the lateral dissection. That is why actually TEM using UC seems to be the technique of choice for many authors [6][7][8].…”

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confidence: 99%

Efficiency and outcomes of harmonic device in transanal endoscopic microsurgery compared with monopolar scalpel

et al. 2011

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“…Regarding surgical technique, we use an ultrasonic scalpel in all resections as it permits good hemostasis control, facilitates vision of the section area and, therefore, decreases surgical time [19]. Recently, we have used LigaSure® on different occasions for intraoperative decapitation of bulky lesions, allowing a better assessment of the pedicle and its resection margins.…”

Section: Discussionmentioning

confidence: 99%

Transanal Endoscopic Microsurgery (TEM) for Rectal Neoplasms

Ferrer-Márquez¹,

Reina-Duarte²,

Rubio-Gil³

et al. 2012

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Introduction:The abdominal approach for the treatment of rectal tumors is associated with a considerable rate of morbidity. Transanal Endoscopic Microsurgery (TEM) is an alternative technique that is less invasive than radical surgery, and therefore has a lower associated morbidity. Moreover, with proper patient selection, TEM presents oncological outcomes comparable to radical surgery. The aim of this study is to review our results obtained with TEM and discuss its role in the treatment of malignant rectal lesions. Patients and Methods: A prospective descriptive study from June 2008 until February 2011. The indications for TEM were: early rectal neoplastic lesions (T 1 N 0 M 0 ) with good prognostic factors; neoplastic lesions in more advanced stages in selected patients (high surgical risk, refusal of radical surgery or stoma, and palliative intention). Results: Resection by TEM was performed on 19 patients. The average hospital stay was 5.7 days with an associated morbidity of 16.7%. R 0 resection was 88.8%. During the follow-up of 15 (3 -31) months, no recurrence has been shown. Conclusions: TEM is a safe and effective procedure for the treatment of selected early malignant rectal lesions and is associated with low morbidity. It is a therapeutic strategy based on a multidisciplinary team, careful patient selection, an audited surgical technique and a strict follow-up protocol.

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Ultracision Harmonic Scalpel and multifunctional tem400 instrument complement in transanal endoscopic microsurgery: a prospective study

Abstract: The UC substantially reduced operative time compared with the T400, but frequently required the T400 for procedure completion. The T400 is always singly sufficient.

Cited by 17 publications

References 28 publications

How to Prevent Lateral Thermal Damage to Tissue Using the Harmonic Scalpel: Experimental Study on Pig Small Intestine and Abdominal Wall

How to Prevent Lateral Thermal Damage to Tissue Using the Harmonic Scalpel: Experimental Study on Pig Small Intestine and Abdominal Wall

Efficiency and outcomes of harmonic device in transanal endoscopic microsurgery compared with monopolar scalpel

Transanal Endoscopic Microsurgery (TEM) for Rectal Neoplasms

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