A new instrument for hemostatic vascular management in endoscopic surgery: diode laser (STATLase-SDL) and its handpiece (dual hook).
OBJECTIVE
The authors described experimental data in hemostatic vascular transection using a STATLase-SDL with a 780-865 nm GaA/As diode wavelength and its handpiece, Dual Hook (DH).


BACKGROUND
The STATLase-SDL and DH are newly developed devices for endoscopic surgery. It seems that the device has improved hemostatic cutting ability.


METHODS
The DH was applied to the abdominal aorta (< 2 mm) of Japanese white rabbits (n = 15) under general anesthesia. Tissue temperature during laser transection and interluminal bursting pressures were measured. Histopathological examinations at the cut end were carried out by hematoxylin-eosin (H&E) and elastica Van Gleson's (EVG) stainings. To investigate short-term effects 11 days postoperatively, the cut ends of the vessels were examined histologically in the heminephrectomy group.


RESULTS
The DH hemostatistically cut through arteries up to 2 mm in diameter. Temperatures at the inner hook and in adjunct tissue were higher than 160 degrees C, while that at the outer hook was lower than 80 degrees C. The bursting pressures immediately after transection was 307.2 +/- 35.2 mm Hg at a laser power of 8 W (n = 5), and 295.6 +/- 28.7 mm Hg at 10 W (n = 5). Histological examination of the transected sites on the vessels revealed well-opposed tissue welding of the vascular wall. Absence of fragmentation in the welding of the internal elastic lamina is crucial for closure of the vessel stump. Up to 11 days postoperatively, there were no direct complications related to the use of the DH.


CONCLUSIONS
The STATLase-SDL and DH have good hemostatic cutting ability and might be suitable for endoscopic surgery.
Morita
T
T
Second Department of Surgery, Saitama Medical School, 38 Moroyama-cho, Iruma-gun, Saitama, Japan.
Okamura
Y
Y
Ookubo
K
K
Tanaka
K
K
Hirayama
R
R
Daikuzono
N
N
D020677:Angioscopes / Q000592:standards*; D017546:Angioscopy / Q000379:methods; D000818:Animals; D001012:Aorta, Abdominal / Q000601:surgery* / Q000648:ultrastructure; D001485:Basement Membrane / Q000648:ultrastructure; D004867:Equipment Design; D006488:Hemostasis, Surgical / Q000295:instrumentation* / Q000379:methods; D053685:Laser Therapy / Q000295:instrumentation* / Q000379:methods; D011312:Pressure; D011817:Rabbits; D012077:Renal Artery / Q000601:surgery* / Q000648:ultrastructure; D013696:Temperature; D013997:Time Factors; D014945:Wound Healing