Early experience with a new 3 mm tissue & vessel sealing device

Steven Rothenberg, MD, FACS, FAAP. Rocky Mountain Hospital for Children

Purpose: To evaluate the functionality of a new 3mm vessel and tissue sealing device in neonates and children.

Methods: Over a 1 year period 89 patients underwent laparoscopic and thoracoscopic procedures using a new 3 mm tissue sealing device. The device is a 3mm instrument with a 1 cm Maryland style grasper/dissector capable of sealing vessels up to 5mm in diameter. The generator uses low bipolar RF output, which limits collateral tissue damage. Ages ranged from 1 day to 12 years and weight from 1.1 kg to 50kg. Procedures included Thoracoscopic lobectomy (24), Fundoplication (26), Thoracic Duct ligation (4), Lap assisted anorectal pull-thru (10), Choledochocyst excision (3), Malrotation (8), PDA ligation (9), Colectomy for NEC stricture (4), Appendectomy (1).

Results: All procedures were completed successfully endoscopically. The device was used in all cases for tissue grasping, dissection, and to seal all blood vessels taken during the procedure. The number of seals performed ranged from 10 to 160 seals. There were no failed vessel seals when the device cycled properly. In one case the device was exchanged after 80 seals because of a fault in the device. The second device performed properly. The device was easily inserted through a 3mm re-usable trocar.

Conclusion: A new 3mm vessel and tissue sealer using a lower more efficient energy profile and RF bipolar technology, works safely and effectively in a wide range of cases. The 3mm shaft and 1 cm jaw design allow for excellent tissue manipulation and dissection in even small premature infants, and allows entry through a 3mm trocar limiting the number of larger ports needed. The design limits the number of instrument changes as all dissection and tissue sealing can be done with a single instrument. Further evaluation is necessary to determine the full range and application of the device

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