Advances in Vessel Sealing and Dissection with Ultrasonic Energy

Juncosa-Melvin N, Pineda JA, Kane K, Clymer JW* and Ricketts CD

Ethicon, Inc., Cincinnati OH, USA

^*Correspondance to: Jeffrey W Clymer 

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Abstract:

Background: Harmonic ultrasonic surgical devices, compared to conventional electrosurgery, are associated with superior coagulation, less thermal damage, reduced production of surgical smoke, and improved surgical outcomes. Prior to the introduction of the Harmonic ACE+7 Shears in 2014, vessel sealing with purely ultrasonic devices was limited to vessels up to 5 mm in diameter. With the advent of Advanced Hemostasis Technology, ACE+7 was able to seal vessels up to 7 mm with high reliability and strength, and its clinical utility has been demonstrated in numerous studies. Since that time, progress in ultrasonic vessel sealing technology has enabled further advances in the use of the device, resulting in the new Harmonic 700 Shears with Advanced Hemostasis. This paper evaluates this device and compares its function to its predecessor, ACE+7. Methods: Harmonic 700 was compared to ACE+7 for pad life, transection time, burst pressure and tissue sticking. Both devices were also compared for vessel sealing acutely in an in vivo porcine model, and in a one-month survival study. Results: Harmonic 700 demonstrated significantly longer pad life, shorter transection time, higher burst pressures and less tissue sticking than ACE+7. In the acute in vivo study, Harmonic 700 displayed higher reliability in a simulated hypertensive crisis model. In the survival study, all seals were maintained for the duration of the postoperative period. Thermal damage remained under 2 mm lateral spread. Conclusion: While advanced bipolar devices were first capable of large vessel sealing, ultrasonic devices have now surpassed them with stronger seals and meticulous dissection capabilities. The new Harmonic 700 performed as well as or better than its predecessor in benchtop and in vivo testing. Based on historical experience, clinical outcomes are also expected to improve.

Keywords:

Ultrasonic vessel sealing; Harmonic scalpel; Large vessel sealing; Hemostasis; Tissue sticking

Cite the Article:

Juncosa-Melvin N, Pineda JA, Kane K, Clymer JW, Ricketts CD. Advances in Vessel Sealing and Dissection with Ultrasonic Energy. World J Surg Surgical Res. 2024; 7: 1544..