Yuichi Nishihara, MD1, Yusuke Watanabe, MD2, Takahiro Homma3, Toshiro Tanioka, MD4, Yasuhito Tanase, MD5, Tomokazu Kishiki, MD6. 1Department of Surgery, National Hospital Organization Tokyo Medical Center, 2Department of Gastroenterological Surgery II, Hokkaido University Faculty of Medicine, 3Department of General Thoracic and Cardiovascular Surgery, University of Toyama, 4Department of Gastric Surgery, Tokyo Medical and Dental University, 5Department of Obstetrics and Gynecology, Nara Medical University, 6Department of Surgery, Kyorin University School of Medicine
Introduction: Ultrasonic transection and coagulation devices (USD) are commonly used in open and minimally invasive procedures after electrosurgical instruments. There may be latent contents for using USDs that are not taught in the current Fundamental Use of Surgical Energy (FUSE) program. The objective of this study was to identify the further learning objectives for the safe and effective use of USDs.
Methods: A qualitative methodology using a focus group of FUSE certificated surgeons was used to gain an in-depth understanding of the safe and effective use of USDs. The focus group session was conducted under the condition that surgeons were able to use USDs with a piece of flank steak as hands-on. The session was recorded and transcribed. After comparing FUSE contents, learning objectives were generated from the recorded data of the focus group. Experimental and clinical scenarios based on findings identified were corrected.
Results: A total of 6 FUSE certificated surgeons were participated (4 GI surgeons, 1 thoracic surgeon, and 1 GYN). The following learning themes were generated from the data: the detailed explanation of cavitation, the tissue injury mechanisms that are different from cavitation, the difference in lateral thermal effect based on philosophy between USDs and vessel sealing devices, the characteristics of blade temperature among devices and temperature trends during activation, the difference in blade temperature based on different techniques (fine, piecemeal, bit by bit cutting technique increases blade temperature significantly and rapidly compared to full-length, chunk cutting), difference in vessel sealing between arteries and veins, and the unknown possibility of tumor cell dissemination. Some experimental and clinical scenarios regarding findings identified will be demonstrated.
Conclusions: Several specific matters for the safe and effective use of USD were identified. Some themes that emerged can be used to focus research in areas to advance in-depth understanding. The learning objectives identified can be used to enrich the existing FUSE program.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 95550
Program Number: P394
Presentation Session: Poster Session (Non CME)
Presentation Type: Poster