Department of Research and Development for Innovative Medical Devices and Systems, 13051Shiga University of Medical Science, Otsu, Shiga, Japan.
Department of Surgery, 37574University of Medicine and Pharmacy at Ho Chi Minh City, Vietnam.
Surg Innov. 2020 Dec;27(6):633-643. doi: 10.1177/1553350620937860. Epub 2020 Jul 2.
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. 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. 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, < .05; vs 833.1 ± 251.2 mmHg, = .4523, respectively) but was not statistically different on veins (324.9 ± 203.5 vs 460.1 ± 320.3 vs 508.3 ± 350.7 mmHg, = .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. 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.
超声激活解剖刀(UAD)和基于射频的设备因其可靠性和灵活性而被认为是出色的手术设备。同时,基于微波的设备因其独特的加热机制而显示出潜力。本研究旨在比较一种新发明的类似镊子的微波密封器(MS)与现有的 UAD 的密封功能。MS 和 2 种 UAD(Harmonic Focus+[HF+]和 Sonicision[SNC])用于进行肠系膜切除术(体内)和密封大血管(体外)。记录血管直径、密封时间、爆裂压力(BP)、密封完成情况和器械粘连。对样本进行组织学检查以评估热损伤。在肠系膜切除术中,MS 需要 3 秒和 30 W 即可完全密封。MS 密封的 BP 高于 HF+和 SNC 在动脉上的 BP(851 ± 203.7 对 682.4 ± 287.3,<.05;对 833.1 ± 251.2 mmHg, =.4523,分别),但在静脉上无统计学差异(324.9 ± 203.5 对 460.1 ± 320.3 对 508.3 ± 350.7 mmHg, =.215)。在所有试验中,MS 引起的粘连较少,但与 UAD 产生的热诱导改变相似。MS 的热扩散在动脉或静脉上均不比 UAD 更广泛。MS 不仅能够密封细小的血管,还能够在大血管上实现高压力耐受性。其强大的抓握和同步加热过程有助于形成可接受热扩散的坚固残端。