Evaluation of thermal effects of surgical energy devices: ex vivo study

Abstract This study evaluated the direct and indirect thermal effects of various surgical energy devices using an ex-vivo model. Two types of three devices were evaluated: ENSEAL™ X1 Curved Jaw Tissue Sealer (X1) and ENSEAL™ G2 Curved Tissue Sealer (G2) as vessel sealing systems (VSSs), and HARMONIC...

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Main Authors: Toshiharu Morikawa, Shuzo Hamamoto, Masakazu Gonda, Kazumi Taguchi, Rei Unno, Koei Torii, Masahiko Isogai, Kengo Kawase, Takashi Nagai, Shoichiro Iwatsuki, Toshiki Etani, Taku Naiki, Atsushi Okada, Takahiro Yasui
Format: Article
Language:English
Published: Nature Portfolio 2024-11-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-024-78624-8
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author Toshiharu Morikawa
Shuzo Hamamoto
Masakazu Gonda
Kazumi Taguchi
Rei Unno
Koei Torii
Masahiko Isogai
Kengo Kawase
Takashi Nagai
Shoichiro Iwatsuki
Toshiki Etani
Taku Naiki
Atsushi Okada
Takahiro Yasui
author_facet Toshiharu Morikawa
Shuzo Hamamoto
Masakazu Gonda
Kazumi Taguchi
Rei Unno
Koei Torii
Masahiko Isogai
Kengo Kawase
Takashi Nagai
Shoichiro Iwatsuki
Toshiki Etani
Taku Naiki
Atsushi Okada
Takahiro Yasui
author_sort Toshiharu Morikawa
collection DOAJ
description Abstract This study evaluated the direct and indirect thermal effects of various surgical energy devices using an ex-vivo model. Two types of three devices were evaluated: ENSEAL™ X1 Curved Jaw Tissue Sealer (X1) and ENSEAL™ G2 Curved Tissue Sealer (G2) as vessel sealing systems (VSSs), and HARMONIC® HD1000i Shears (HA) as an ultrasonic activating device (USAD). Each device was activated once under DRY or WET conditions. The tissue’s maximum temperature (MT), steam MT surrounding the activation site, and steam spread area (SSA) were measured. Under WET conditions, the median MT of a porcine common carotid artery at 1 mm from the activation site by X1, G2, and HA were 84.4, 83.3, and 50.5 °C, respectively. The direct thermal effect of HA was the lowest among the three devices. VSSs showed higher tissue MT under WET conditions compared with DRY conditions. Conversely, USAD showed the opposite trend. G2 demonstrated a significantly higher MT than X1 and HA (P < 0.05). A significant decrease in SSA was observed with decreasing grasping range. In conclusion, VSSs generated higher temperatures than USAD, especially under WET conditions. Surgeons should consider minimizing thermal effects by creating DRY conditions or performing gradual incisions when using VSS devices.
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spelling doaj-art-6cdd5a3a281a4fe19036fdda9a9e45dc2024-11-10T12:17:49ZengNature PortfolioScientific Reports2045-23222024-11-011411910.1038/s41598-024-78624-8Evaluation of thermal effects of surgical energy devices: ex vivo studyToshiharu Morikawa0Shuzo Hamamoto1Masakazu Gonda2Kazumi Taguchi3Rei Unno4Koei Torii5Masahiko Isogai6Kengo Kawase7Takashi Nagai8Shoichiro Iwatsuki9Toshiki Etani10Taku Naiki11Atsushi Okada12Takahiro Yasui13Department of Nephro-urology, Nagoya City University Graduate School of Medical SciencesDepartment of Nephro-urology, Nagoya City University Graduate School of Medical SciencesDepartment of Urology, Nagoya City University Midori Municipal HospitalDepartment of Urology, Nagoya City University East Medical CenterDepartment of Nephro-urology, Nagoya City University Graduate School of Medical SciencesDepartment of Nephro-urology, Nagoya City University Graduate School of Medical SciencesDepartment of Nephro-urology, Nagoya City University Graduate School of Medical SciencesDepartment of Nephro-urology, Nagoya City University Graduate School of Medical SciencesDepartment of Nephro-urology, Nagoya City University Graduate School of Medical SciencesDepartment of Nephro-urology, Nagoya City University Graduate School of Medical SciencesDepartment of Nephro-urology, Nagoya City University Graduate School of Medical SciencesDepartment of Urology, Nagoya City University West Medical CenterDepartment of Nephro-urology, Nagoya City University Graduate School of Medical SciencesDepartment of Nephro-urology, Nagoya City University Graduate School of Medical SciencesAbstract This study evaluated the direct and indirect thermal effects of various surgical energy devices using an ex-vivo model. Two types of three devices were evaluated: ENSEAL™ X1 Curved Jaw Tissue Sealer (X1) and ENSEAL™ G2 Curved Tissue Sealer (G2) as vessel sealing systems (VSSs), and HARMONIC® HD1000i Shears (HA) as an ultrasonic activating device (USAD). Each device was activated once under DRY or WET conditions. The tissue’s maximum temperature (MT), steam MT surrounding the activation site, and steam spread area (SSA) were measured. Under WET conditions, the median MT of a porcine common carotid artery at 1 mm from the activation site by X1, G2, and HA were 84.4, 83.3, and 50.5 °C, respectively. The direct thermal effect of HA was the lowest among the three devices. VSSs showed higher tissue MT under WET conditions compared with DRY conditions. Conversely, USAD showed the opposite trend. G2 demonstrated a significantly higher MT than X1 and HA (P < 0.05). A significant decrease in SSA was observed with decreasing grasping range. In conclusion, VSSs generated higher temperatures than USAD, especially under WET conditions. Surgeons should consider minimizing thermal effects by creating DRY conditions or performing gradual incisions when using VSS devices.https://doi.org/10.1038/s41598-024-78624-8Vessel sealing systemUltrasonic activating deviceThermal effectGrasping rangeSteam spread areaWET condition
spellingShingle Toshiharu Morikawa
Shuzo Hamamoto
Masakazu Gonda
Kazumi Taguchi
Rei Unno
Koei Torii
Masahiko Isogai
Kengo Kawase
Takashi Nagai
Shoichiro Iwatsuki
Toshiki Etani
Taku Naiki
Atsushi Okada
Takahiro Yasui
Evaluation of thermal effects of surgical energy devices: ex vivo study
Scientific Reports
Vessel sealing system
Ultrasonic activating device
Thermal effect
Grasping range
Steam spread area
WET condition
title Evaluation of thermal effects of surgical energy devices: ex vivo study
title_full Evaluation of thermal effects of surgical energy devices: ex vivo study
title_fullStr Evaluation of thermal effects of surgical energy devices: ex vivo study
title_full_unstemmed Evaluation of thermal effects of surgical energy devices: ex vivo study
title_short Evaluation of thermal effects of surgical energy devices: ex vivo study
title_sort evaluation of thermal effects of surgical energy devices ex vivo study
topic Vessel sealing system
Ultrasonic activating device
Thermal effect
Grasping range
Steam spread area
WET condition
url https://doi.org/10.1038/s41598-024-78624-8
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