Evaluation of Vessel Sealing Performance Among Ultrasonic Devices in a Porcine Model
Evaluation of Vessel Sealing Performance Among Ultrasonic Devices in a Porcine Model
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DOI：
10.1177/1553350615579730
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发表时间：
2015-08-01
影响因子：
1.5
通讯作者：
Ujiki, Michael
中科院分区：
文献类型：
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作者：
Tanaka, Ryota;Gitelis, Matthew;Ujiki, Michael
背景随着新技术的出现，必须确定哪些新器械最有可能为患者和外科医生提供可重现的有效结果。本研究旨在分析3种市售超声能量器械：Sonicision（SC）、Harmonic ACE（HA）和THUNDERBEAT（TB）。材料和方法。8头雌性约克郡猪用于数据收集和血管收获。评价了三种器械，并就体内密封失效和切割速度进行了相互比较。血管采集后，将碎片的一端送去进行组织学评价，另一端以设盲方式用于爆破压力测量试验。将所有发生器的凝血和切割水平设置为相似且恒定的水平。结果对84条血管（47条动脉和37条静脉）进行了试验。各组的平均血管直径相等。TB的切割速度（3.4 +/- 0.7秒）明显快于SC或HA（5.8 +/- 2.4和6.1 +/- 3.1秒; P <0.0001）。TB结扎后的爆破压（505.4 +/- 349.4 mm Hg）高于SC和HA（435.8 +/- 403.0和437.6 +/- 291.3 mm Hg）。SC组和HA组中有2例凝闭失败，TB组中无一例。组织学上，TB的组织凝闭垂直宽度（1.250 +/- 0.55 mm）显著长于SC和HA（0.772 +/- 0.23和0.686 +/- 0.23 mm; P <0.0001）。结论. TB已被证明可提供最快速和可靠的密封。因此，TB可能更安全，并可能减少手术时间。
Background. As new technologies emerge, it is imperative to define which new devices are most likely to provide a reproducible, effective result for the patient and surgeon. The purpose of our study was to analyze 3 commercially available ultrasonic energy devices; the Sonicision (SC), the Harmonic ACE (HA), and the THUNDERBEAT (TB). Material and Methods. Eight female Yorkshire pigs were used for data collection and vessel harvest. Three devices were evaluated and compared with each other with respect to seal failure and cutting speed in vivo. After vessel harvest, one end of the fragment was sent for histological evaluation, and the other was used for burst pressure measurement testing in a blinded fashion. The coagulation and cut levels of all the generators were set up at a similar and constant level. Results. Eighty-four vessels (47 arteries and 37 veins) were tested. Mean vessel diameter was equal among the groups. Cutting speed was significantly faster with TB (3.4 +/- 0.7 seconds) than SC or HA (5.8 +/- 2.4 and 6.1 +/- 3.1 seconds; P < .0001). Burst pressure trended higher after ligation with TB (505.4 +/- 349.4 mm Hg) than SC and HA (435.8 +/- 403.0 and 437.6 +/- 291.3 mm Hg). There were 2 seal failures in the SC group and HA group and none in the TB group. Histologically, the perpendicular width of tissue seal with TB (1.250 +/- 0.55 mm) was significantly longer than that of the SC and the HA (0.772 +/- 0.23 and 0.686 +/- 0.23 mm; P < .0001). Conclusions. TB has proven to provide the most rapid and reliable seal. Therefore, TB may be safer and may decrease time during surgical procedures.