The approach of general surgeons to the use of vessel sealing device in thyroid surgery

Introduction: Bipolar electrocautery devices used to achieve intraoperative hemostasis carry risk of imparting thermal energy to adjacent tissue, leading to postoperative morbidity. The aim of this study was to compare a new vessel sealing device, the CoolSeal™ Reveal (Bolder Surgical, Louisville, Colorado), with an established industry standard device, the LigaSure™ Exact Dissector (Valleylab, Boulder, Colorado), to assess their safety and the extent to which they impart thermal damage to tissue during thyroid surgery. Materials and Methods: Vascular bundles associated with the thyroid gland in anesthetized sheep were exposed and sealed with a single activation of each device and excised en bloc. Additionally, vascular structures of the sheep were also sealed 0, 1, or 2mm adjacent to the recurrent laryngeal nerve (RLN). Vascular and RLN samples were processed for histopathologic evaluation and assessed for extent of thermal injury, seal width, and coagulative changes. Results: The mean thermal injury extent across all sample sizes and vessel types was significantly lower for the CoolSeal™ Reveal device (547.2 ± 27.9μm) compared to the LigaSure™ device (802.7± 48.6μm) (p<0.001). Seal widths were significantly smaller in samples sealed with the CoolSeal™ Reveal device (899.0 ± 14.9μm) than samples sealed with the LigaSure™ device (1645.3 ± 160.3μm) (p<0.001). Conclusion: The CoolSeal™ Reveal device demonstrates significantly lower thermal spread in vivo compared to the LigaSure™ Exact Dissector. These results indicate that the CoolSeal™ Reveal is an effective tool for sealing blood vessels and minimizing thermal damage to adjacent structures during delicate surgeries or in narrow surgical fields associated with the thyroid gland.

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Partial hepatectomy for treatment of multiple liver abscess in a calf: a case report

BMC Veterinary Research ◽

10.1186/s12917-021-02750-y ◽

2021 ◽

Vol 17 (1) ◽

Author(s):

Reiichiro Sato ◽

Kazutaka Yamada ◽

Taiki Yokoyama ◽

Koki Tanimoto ◽

Shoko Takeuchi ◽

...

Keyword(s):

Case Report ◽

Partial Hepatectomy ◽

Liver Abscess ◽

Bacterial Infections ◽

Umbilical Vein ◽

Abdominal Cavity ◽

Left Liver Lobe ◽

Vessel Sealing ◽

Liver Abscesses ◽

Sealing Device

Abstract Background Umbilical vein bacterial infections may cause liver abscesses during bacterial ascent. A single liver abscess can be surgically treated by marsupialization, but a risk of recurrence or non-healing remains. Moreover, there is no effective treatment for multiple abscesses. Case presentation A 17-day-old Holstein female calf exhibited reduced general condition, swelling and drainage of the umbilicus, and pressure sores in the area of the carpus, resulting in reluctance to stand up. The umbilicus showed pain at palpation; deep abdominal palpation indicated a swollen umbilical vein coursing from the umbilicus toward the liver. Ultrasonography confirmed a swollen umbilical vein with pus accumulation and multiple abscesses in the liver. Contrast-enhanced computed tomography (CT) examination confirmed that the swollen umbilical vein with fluid continued to the liver, and multiple unenhanced lesions, most likely abscesses, were confirmed in the liver. Partial hepatectomy was performed to remove as many abscesses as possible. For the resection, a vessel sealing device (LigaSureTM) was used to excise a part of the left liver lobe. As we could not remove all the abscesses in the liver during the operation, cefazolin sodium (5 mg/kg) was administered for 14 days after surgery. Post-operatively, blood accumulation was observed in the abdominal cavity, but no signs of peritonitis were found. The calf returned to the farm on day 38 after surgery. Follow-up information was obtained after 1 year, and complications were not reported. Conclusions To our knowledge, this is the first report of partial hepatectomy using a vessel sealing device for a calf with multiple liver abscesses. This case report suggests that the combination of partial hepatectomy and long-term administration of antibacterial drugs may restore the health of calves with multiple liver abscesses.

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Evaluation of a vessel-sealing device for use in laparoscopic ovariectomy in mares

Veterinary Surgery ◽

10.1053/jvet.2002.33482 ◽

2002 ◽

Vol 31 (3) ◽

pp. 240-244 ◽

Cited By ~ 57

Author(s):

Reese Hand ◽

Peter Rakestraw ◽

Tex Taylor

Keyword(s):

Vessel Sealing ◽

Sealing Device

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Morbidity reduction using the vessel sealing device LigaSure™ in breast cancer surgery

European Surgery ◽

10.1007/s10353-015-0334-8 ◽

2015 ◽

Vol 47 (4) ◽

pp. 150-156

Author(s):

P. Panhofer ◽

S. Rothe ◽

M. Schütz ◽

B. Grohmann-Izay ◽

P. Dubsky ◽

...

Keyword(s):

Breast Cancer ◽

Cancer Surgery ◽

Breast Cancer Surgery ◽

Vessel Sealing ◽

Sealing Device

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Feasibility and Safety of Canine Orchiectomy Using Scrotal Approach and a Vessel-Sealing Device: A Prospective Observational Study of 200 Cases

10.21203/rs.3.rs-818635/v1 ◽

2021 ◽

Author(s):

Christos Yiapanis ◽

Ciprian Ober ◽

Maria Potamopoulou ◽

Theodoros Vasilakis ◽

Joshua Milgram

Keyword(s):

Spermatic Cord ◽

Prospective Observational Study ◽

Postoperative Morbidity ◽

Categorical Variables ◽

Surgical Time ◽

Widespread Application ◽

Vessel Sealing ◽

Additional Surgery ◽

Monopolar Electrosurgery ◽

Sealing Device

Abstract Background: Canine orchiectomy involves making an incision in the prescrotal area, exteriorizing both testes via the same incision, ligating the blood vessels and spermatic cord, removing the testes, and suturing the incision. A briefer durations of anesthesia and surgery and decrease of postoperative morbidity could be obtain using a vessel sealing device. The aim of this study was to determine the feasibility and safety of orchiectomy in dogs by a scrotal approach with the use of a vessel-sealing device. Scrotal orchiectomy was performed with the use of monopolar electrosurgery device in pure cutting mode and a vessel-sealing device. Data were collected prospectively for the following categorical variables: breed, age, body weight, lifestyle, surgical time, indications for surgery and complications.Results: No complications were reported in 187 of 200 (93.5%). The complications documented were automutilation (AM), incisional complications (IC) and scrotal complications (SC). AM complications (11/200 [5.5%]) and SC complications (2/200 [1%]) were treated without additional surgery and resolved by day 10 after the surgery. Procedure duration (2,1 minutes± 0.4 minutes) was briefer than traditional castration duration reported in literature (3.5 ± 0.4 minutes).Conclusions: Results suggested that canine orchiectomy by scrotal approach with the use of a vessel-sealing device was feasible and safe. Furthermore, it was associated with a low complication rate and had the benefit of reduced surgical time and postoperative morbidity. This technique is promising for widespread application in veterinary surgery to help with haemostasis in canine orchiectomy.

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Evaluation of a vessel-sealing device to assist eye enucleation and exenteration in the horse

Equine Veterinary Education ◽

10.2746/095777309x477834 ◽

2009 ◽

Vol 21 (11) ◽

pp. 596-601 ◽

Cited By ~ 4

Author(s):

M. T. Launois ◽

J. M. E. F. Vandeweerd ◽

R. A. R. Perrin ◽

L. Brogniez ◽

A. Gabriel ◽

...

Keyword(s):

Eye Enucleation ◽

Vessel Sealing ◽

Sealing Device

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Complete resection of the alar folds in eight standing horses with a bipolar dividing and vessel‐sealing device

Veterinary Surgery ◽

10.1111/vsu.13383 ◽

2020 ◽

Vol 49 (3) ◽

pp. 521-528

Author(s):

Airina Kallmyr ◽

Ellen M. Giving ◽

Lars O. Moen ◽

Marianne Øverlie ◽

Therese Holm ◽

...

Keyword(s):

Complete Resection ◽

Vessel Sealing ◽

Sealing Device

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Vessel-sealing device versus other hemostatic techniques in thyroidectomy in dogs

Advances in Small Animal Medicine and Surgery ◽

10.1016/j.asams.2019.12.008 ◽

2019 ◽

Vol 32 (12) ◽

pp. 8

Keyword(s):

Vessel Sealing ◽

Sealing Device

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Comparison of a 5-mm and 10-mm vessel sealing device in an open ovariectomy model in dogs

Veterinary Record ◽

10.1136/vr.104016 ◽

2017 ◽

Vol 180 (17) ◽

pp. 425-425 ◽

Cited By ~ 3

Author(s):

N. Devriendt ◽

B. Van Goethem ◽

L. Van Brantegem ◽

M. De Ridder ◽

A. Kitshoff ◽

...

Keyword(s):

Vessel Sealing ◽

Sealing Device

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Energy Based Vessel Sealing Devices in Thyroid Surgery: A Systematic Review to Clarify the Relationship with Recurrent Laryngeal Nerve Injuries

Medicina ◽

10.3390/medicina56120651 ◽

2020 ◽

Vol 56 (12) ◽

pp. 651

Author(s):

Mario Pacilli ◽

Nicola Tartaglia ◽

Alberto Gerundo ◽

Giovanna Pavone ◽

Alberto Fersini ◽

...

Keyword(s):

Recurrent Laryngeal Nerve ◽

Thyroid Surgery ◽

Current Knowledge ◽

Operating Time ◽

Laryngeal Nerve ◽

Injury Rates ◽

Operative Outcomes ◽

Vessel Sealing ◽

Number Of Patients ◽

Efficient Alternative

Background and objectives: The principal complications associated with thyroid surgery consist in postoperative recurrent laryngeal nerve (RLN) palsy, hypoparathyroidism, intra-operative and post-operative hemorrhage. In this paper, structured as a literature review, we describe the current knowledge and the technical improvements currently employed in the field of thyroid surgery, focusing on the contribution of energy based devices in relation with the reduction of the operating time and the odds of possible complication. Materials and methods: a relevant systematic literature search on Pubmed was carried out including works from 2004 through 2019, selecting studies providing information on the energy based devices employed in surgeries and statistic data concerning RNL (transient and permanent) injury and operative time. Results: Nineteen studies were reviewed, dealing with 4468 patients in total. The operative variables considered in this study are: employed device, number of patients, pathological conditions affecting the patients, surgical treatment, RNL injury percentage and the operating time, offering an insight on different patient conditions and their relative operative outcomes. A total of 1843 patients, accounting to the 41.2% of the total pool, underwent the traditional technique operation, while 2605 patients (58.3%) were treated employing the energy based devices techniques. Thyroidectomy performed by approaches different from traditional (for example robotic, MIVAT (Mini Invasive Video Assisted thyroidectomy)) were excluded from this study. Conclusions: The energy-based vessel sealing devices in study, represent a safe and efficient alternative to the traditional clamp-and-tie hand technique in the thyroidal surgery scenario, granting a reduction in operating time while not increasing RNL injury rates. According to this information, a preference for energy based devices techniques might be expressed, furthermore, a progressively higher usage rate for these devices is expected in the near future.

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