The Thermal Safety Profile of a New Bipolar Vessel Sealing Device for Thyroid Surgery

2021 ◽  
Vol 39 ◽  
Author(s):  
Aman Prasad ◽  
◽  
Jessica Durrant ◽  
Daniel Smeak ◽  
Jason Newman ◽  
...  
Keyword(s):  
Thyroid Gland ◽  
Thyroid Surgery ◽  
Thermal Injury ◽  
Thermal Damage ◽  
Vascular Bundles ◽  
En Bloc ◽  
Vessel Sealing ◽  
Adjacent Structures ◽  
Sealing Device

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.

Vessel-Sealing Capability of Novel Microwave Sealer: Experimental Study in Animal Models

2020 ◽  
pp. 155335062093786
Author(s):  
Khiem Tran Dang ◽  
Shigeyuki Naka ◽  
Atsushi Yamada ◽  
Ken-ichi Mukaisho ◽  
Tohru Tani
Keyword(s):  
Thermal Damage ◽  
Ex Vivo ◽  
Vessel Diameter ◽  
Heating Process ◽  
Damage Evaluation ◽  
Vessel Sealing ◽  
Surgical Devices ◽  
Harmonic Focus ◽  
Thermal Spread

Background. Ultrasonically activated dissectors (UADs) and radiofrequency-based devices have been considered excellent surgical devices because of their reliability and flexibility. Meanwhile, microwave-based devices have demonstrated potential with their unique heating mechanism. This study aims to compare the sealing function of a newly invented forceps-like microwave sealer (MS) with that of currently available UADs. Materials and Methods. MS and 2 examples of UADs (Harmonic Focus+ [HF+] and Sonicision [SNC]) were employed to perform mesenterectomies (in vivo) and sealing sizable vessels (ex vivo). Vessel diameter, seal time, burst pressure (BP), sealing completion, and instrument sticking were recorded. The samples underwent histological investigation for thermal damage evaluation. Results. During mesenterectomies, MS required 3 seconds and 30 W to secure a complete seal. The BP achieved by the MS seal was higher than that of HF+ and SNC on arteries (851 ± 203.7 vs 682.4 ± 287.3, P < .05; vs 833.1 ± 251.2 mmHg, P = .4523, respectively) but was not statistically different on veins (324.9 ± 203.5 vs 460.1 ± 320.3 vs 508.3 ± 350.7 mmHg, P = .215). In all trials, MS caused less sticking but exhibited similar heat-induced alterations to UADs. MS’s thermal spread was not statistically more extended than that of UADs on either arteries or veins. Conclusions. MS was capable of not only sealing tiny vessels but also achieving high-pressure endurance on sizable vessels. Its forceful grasping and synchronous heating process helped create solid stumps with an acceptable thermal spread.

scholarly journals Experimental assessment of three electrosurgical tissue-sealing devices in a porcine model

2020 ◽  
Author(s):  
Miklós Pál Dunay ◽  
Zsuzsanna Lipcsey ◽  
Attila Arany-Tóth ◽  
Tibor Németh ◽  
Norbert Solymosi ◽  
...  
Keyword(s):  
Thermal Injury ◽  
Thermal Damage ◽  
Porcine Model ◽  
Striated Muscle ◽  
Tissue Integrity ◽  
Working Temperature ◽  
Significant Difference ◽  
Higher Temperature ◽  
Tissue Sealing

AbstractThree electrosurgical tissue-sealing devices (EnSeal ETSDRC-01, LigaSure LS1500 and Thunderbeat TB-0535PC) were compared regarding sealing time (ST), maximum working temperature (WTmax) and the total (MTZtotal) as well as the collateral microscopic thermal injury zone (MTZcollat) using laparoscopic handpieces 5 mm in diameter on four types of tissue (liver, mesentery, cross striated muscle and spleen) in an in vivo porcine model. LigaSure had the lowest mean ST in spleen, mesentery, muscle and liver, followed by Thunderbeat and EnSeal with significant differences between all types of tissues and devices. The significantly lowest mean WTmax was obtained for EnSeal in mesentery, muscle and liver. LigaSure and EnSeal operated at the lowest temperature in spleen without a significant difference between them. Thunderbeat produced significantly higher temperature peaks in all cases. The lowest mean MTZtotal was caused by LigaSure and EnSeal in spleen, mesentery and muscle without significant differences between them, followed by the significantly higher values of Thunderbeat. Nevertheless, Thunderbeat produced the significantly lowest mean MTZtotal in the liver. EnSeal produced the lowest mean MTZcollat in the liver, followed by LigaSure and Thunderbeat showing significant differences. EnSeal and LigaSure produced the lowest mean MTZcollat in the spleen, mesentery and muscle without significant differences between them, followed by the significantly higher values of Thunderbeat. Based on the results of this study, Thunderbeat seems to be more invasive to tissue integrity (even without the activation of the ultrasonic scissor function) than EnSeal or LigaSure, that operate at lower temperatures and were found to cause negligible collateral thermal damage.

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

2014 ◽  
Vol 30 (4) ◽  
pp. 197-200
Author(s):  
Burhan Mayir ◽  
Tuna Bilecik ◽  
Cemal Ozben Ensari ◽  
Erdem Can Yardimci ◽  
Mehmet Tahir Oruc
Keyword(s):  
Thyroid Surgery ◽  
Vessel Sealing ◽  
General Surgeons ◽  
Sealing Device

Osseointegration interface of calcified bone and endosseous implants

1992 ◽  
Vol 50 (2) ◽  
pp. 1096-1097
Author(s):  
K.E. Krizan ◽  
J.E. Laffoon ◽  
M.J. Buckley
Keyword(s):  
Structure And Function ◽  
Titanium Implants ◽  
En Bloc ◽  
Endosseous Implants ◽  
Ultrastructural Studies ◽  
The Past ◽  
Cacodylate Buffer ◽  
One Year ◽  
And Function

With increase use of tissue-integrated prostheses in recent years it is a goal to understand what is happening at the interface between haversion bone and bulk metal. This study uses electron microscopy (EM) techniques to establish parameters for osseointegration (structure and function between bone and nonload-carrying implants) in an animal model. In the past the interface has been evaluated extensively with light microscopy methods. Today researchers are using the EM for ultrastructural studies of the bone tissue and implant responses to an in vivo environment. Under general anesthesia nine adult mongrel dogs received three Brånemark (Nobelpharma) 3.75 × 7 mm titanium implants surgical placed in their left zygomatic arch. After a one year healing period the animals were injected with a routine bone marker (oxytetracycline), euthanized and perfused via aortic cannulation with 3% glutaraldehyde in 0.1M cacodylate buffer pH 7.2. Implants were retrieved en bloc, harvest radiographs made (Fig. 1), and routinely embedded in plastic. Tissue and implants were cut into 300 micron thick wafers, longitudinally to the implant with an Isomet saw and diamond wafering blade [Beuhler] until the center of the implant was reached.

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

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.

scholarly journals Hyperspectral Imagery for Assessing Laser-Induced Thermal State Change in Liver

Sensors ◽  
2021 ◽  
Vol 21 (2) ◽  
pp. 643
Author(s):  
Martina De Landro ◽  
Ignacio Espíritu García-Molina ◽  
Manuel Barberio ◽  
Eric Felli ◽  
Vincent Agnus ◽  
...  
Keyword(s):  
Thermal Damage ◽  
Thermal State ◽  
Preliminary Investigation ◽  
Spectral Band ◽  
Spectral Variation ◽  
Ablation Therapy ◽  
Clinical Endpoints ◽  
Breathing Motion ◽  
Living Tissues

This work presents the potential of hyperspectral imaging (HSI) to monitor the thermal outcome of laser ablation therapy used for minimally invasive tumor removal. Our main goal is the establishment of indicators of the thermal damage of living tissues, which can be used to assess the effect of the procedure. These indicators rely on the spectral variation of temperature-dependent tissue chromophores, i.e., oxyhemoglobin, deoxyhemoglobin, methemoglobin, and water. Laser treatment was performed at specific temperature thresholds (from 60 to 110 °C) on in-vivo animal liver and was assessed with a hyperspectral camera (500–995 nm) during and after the treatment. The indicators were extracted from the hyperspectral images after the following processing steps: the breathing motion compensation and the spectral and spatial filtering, the selection of spectral bands corresponding to specific tissue chromophores, and the analysis of the areas under the curves for each spectral band. Results show that properly combining spectral information related to deoxyhemoglobin, methemoglobin, lipids, and water allows for the segmenting of different zones of the laser-induced thermal damage. This preliminary investigation provides indicators for describing the thermal state of the liver, which can be employed in the future as clinical endpoints of the procedure outcome.

Sign in / Sign up

Export Citation Format

Share Document