1. A new method using a vessel-sealing system provides coagulation effects to various types of bleeding with less thermal damage
- Author
-
Shosaburo Oyama, Naoto Matsuo, Tomohiro Obata, Kouki Wakata, Takashi Nonaka, Tetsuro Tominaga, Takeshi Nagayasu, Makoto Hisanaga, Hideo Wada, Yasumasa Hashimoto, Terumitsu Sawai, Daisuke Taniguchi, Masaaki Moriyama, Keitaro Matsumoto, Kiyoaki Hamada, and Shigekazu Hidaka
- Subjects
Dynamic Manuscript ,Laparoscopic surgery ,Electrosurgery ,Swine ,medicine.medical_treatment ,Hemorrhage ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Animals ,Coagulation (water treatment) ,Mesentery ,Desiccation ,Blood Coagulation ,business.industry ,Stomach ,Flat coagulation ,Temperature ,Vessel sealing ,Thermal damage ,Hemostasis, Surgical ,Vessel-sealing system ,Small intestine ,medicine.anatomical_structure ,Liver ,Thermography ,030220 oncology & carcinogenesis ,Hemostasis ,Swine, Miniature ,030211 gastroenterology & hepatology ,Surgery ,business ,Biomedical engineering ,Abdominal surgery - Abstract
Background Hemostasis is very important for a safe surgery, particularly in endoscopic surgery. Accordingly, in the last decade, vessel-sealing systems became popular as hemostatic devices. However, their use is limited due to thermal damage to organs, such as intestines and nerves. We developed a new method for safe coagulation using a vessel-sealing system, termed flat coagulation (FC). This study aimed to evaluate the efficacy of this new FC method compared to conventional coagulation methods. Methods We evaluated the thermal damage caused by various energy devices, such as the vessel-sealing system (FC method using LigaSure™), ultrasonic scissors (Sonicision™), and monopolar electrosurgery (cut/coagulation/spray/soft coagulation (SC) mode), on porcine organs, including the small intestine and liver. Furthermore, we compared the hemostasis time between the FC method and conventional methods in the superficial bleeding model using porcine mesentery. Results FC caused less thermal damage than monopolar electrosurgery’s SC mode in the porcine liver and small intestine (liver: mean depth of thermal damage, 1.91 ± 0.35 vs 3.37 ± 0.28 mm; p = 0.0015). In the superficial bleeding model, the hemostasis time of FC was significantly shorter than that of electrosurgery’s SC mode (mean, 19.54 ± 22.51 s vs 44.99 ± 21.18 s; p = 0.0046). Conclusion This study showed that the FC method caused less thermal damage to porcine small intestine and liver than conventional methods. This FC method could provide easier and faster coagulation of superficial bleeds compared to that achieved by electrosurgery’s SC mode. Therefore, this study motivates for the use of this new method to achieve hemostasis with various types of bleeds involving internal organs during endoscopic surgeries.
- Published
- 2020