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Laparoscopic ultrasonic dissectors: technology update by a review of literature

Authors Devassy R, Hanif S, Krentel H, Verhoeven HC, Torres-de la Roche LA, De Wilde RL

Received 30 November 2017

Accepted for publication 11 April 2018

Published 27 December 2018 Volume 2019:12 Pages 1—7


Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 2

Editor who approved publication: Dr Scott Fraser

Rajesh Devassy,1 Sadaf Hanif,1 Harald Krentel,2 Hugo C Verhoeven,2 Luz Angela Torres-de la Roche,2 Rudy Leon De Wilde2

1Dubai London Clinic & Specialty Hospital, Dubai, UAE; 2Clinic of Gynecology, Obstetrics and Gynecological Oncology, University Hospital for Gynecology, Carl von Ossietzky University, Pius-Hospital Oldenburg, Oldenburg, Germany

Abstract: The evolution of minimally invasive surgery has brought forward the appearance of new advances in the course of the most recent couple of years and has introduced energy-based devices. The newest among them today are the ultrasonically activated devices, which are utilized with a great deal of components in-play, including ergonomics and financial aspects amid surgery. The methodology embraced was finding significant investigations through studies from PubMed, Medline and Google Scholar on current ultrasonic dissectors, which are Ethicon’s Harmonic Scalpel (ACE®), Covidien’s Sonicision™ (SNC), Conmed’s SonoSurg® (SS) and Olympus’s Thunderbeat®, to describe their efficacy in terms of vessel sealing speed, vessel burst pressure, visibility, operation time and thermal speed. We found postmarketing evidence to determine which device exhibits the better performance. Animal studies showed that emissivity values and maximum temperatures for coagulation are similar among devices but maximum cutting temperatures are significantly different: ACE = 191.1°C, SNC = 227.1°C, SS = 184.8°C (p < 0.001). Cooling times are significantly different among devices: 35.7 s for ACE, 38.7 s for SNC and 27.4 s for SS (p < 0.001). Cooling times of passive jaws to reach 60°C after activation were also significantly different: 25.4 s for ACE, 5.7 s for SNC, and 15.4 s for SS (p < 0.001). The perfect device would unify brilliant hemostatic outcomes with visual sharpness while permitting none or insignificant thermal damage at the place of use.

Keywords: laparoscopy, ultrasonic dissectors, thermal damage, energy devices

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