D Meiselman, Mr, R Tanaka, MD, PhD, M Zapf, Mr, C Karras, Mr, B Abar, Mr, M Feinberg, Mr, J Zhao, MD, M Ujiki, MD. NorthShore Health Care System, Department of Surgery.
INTRODUCTION: 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, while remaining cost effective. The purpose of our study was to analyze the three most commercially available ultrasonic energy devices; the Sonicision™ (SC) (Covidien, USA), the Harmonic ACE™ (HA) (Ethicon Endo-Surgery, USA), and the THUNDERBEAT ™ (TB) (Olympus, Japan).
METHODS: Intra-abdominal vessels (artery and vein) from eight female Yorkshire pigs (30-35 kg) were harvested. Three devices were evaluated and compared to each other with respect to seal failure and cutting speed in vivo. After harvest, one vessel end was sent for histological evaluation, and the other used for blinded burst pressure measurement. Coagulation and cut levels of all generators were set up similarly and consistently throughout the study.
RESULTS: Eighty-four vessels (47 arteries and 37 veins) were tested. Mean vessel diameter was equal among groups: SC (n=29) 4.3±1.3mm, HA (n=29) 4.0±1.7mm, and TB (n=26) 4.0±2.1mm. There were equal numbers of arteries and veins in each group. Cutting speed was significantly faster with TB (3.4±0.7seconds versus SC 5.8±2.4 and HA and 6.1±3.1) (p<.0001). Burst pressure after ligation with TB (505.4±349.4mmHg) was higher than that of the SC and HA (435.8±403.0 and 437.6±291.3, respectively), though not statistically signficant. There were no seal failures in the TB group, and two in each the SC and HA groups (vessel diameter 3.1-7.0mm).
CONCLUSION: TB provides the most rapid and reliable seal in a porcine model and may result in decreased operative time and less blood loss.
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