title: Evaluation of surgical energy devices for vessel sealing and peripheral energy spread in a porcine model.
abstract: OBJECTIVE
  Vessel sealing capabilities and the peripheral energy spread associated with currently available energy based surgical instruments were evaluated.
  
  
  METHODS
  Four groups of energy based surgical instruments were established for evaluation, including the ACE, LCS-C5 (Ethicon, Cincinnati, Ohio), LigaSure V and the prototype Trissector. In vivo vessel diameter under physiological conditions, bursting pressures and seal failure were recorded and analyzed for arteries and veins separately. After burst testing the vessels were fixed and evaluated histopathologically for peripheral energy damage. ANOVA was used to determine differences between groups.
  
  
  RESULTS
  The LigaSure V sealed arteries and veins with an average burst pressure of 536 and 386 mm Hg, respectively. The Harmonic ACE sealed arteries and veins with an average burst pressure of 436 and 160 mm Hg, respectively. The Harmonic LCS-C5 sealed arteries and veins with an average burst pressure of 363 and 215 mm Hg, respectively. The Trissector sealed arteries and veins with an average burst pressure of 328 and 237 mm Hg, respectively. For arteries the ACE, LCS-C5, Trissector and LigaSure V measured a full-thickness peripheral energy spread of 0.6, 0.3, 8.0 and 4.5 mm, respectively (p <0.0001). For veins the ACE, LCS-C5, Trissector and LigaSure V measured a full-thickness peripheral energy spread of 1.5, 1.3, 8.5 and 6.3 mm, respectively (p = 0.003).
  
  
  CONCLUSIONS
  The LigaSure 5 was superior to the other devices tested regarding the ability to seal vessels up to 7 mm. The ACE is an efficient vessel sealing system with the ability to seal vessels up to 5 mm.
authors.affiliation: Department of Urology, Columbia University Medical Center, New York, New York, USA.
authors.forename: Gregory W
authors.initials: GW
authors.lastname: Hruby
authors.forename: Franzo C
authors.initials: FC
authors.lastname: Marruffo
authors.forename: Evren
authors.initials: E
authors.lastname: Durak
authors.forename: Sean M
authors.initials: SM
authors.lastname: Collins
authors.forename: Phillip
authors.initials: P
authors.lastname: Pierorazio
authors.forename: Peter A
authors.initials: PA
authors.lastname: Humphrey
authors.forename: Mahesh M
authors.initials: MM
authors.lastname: Mansukhani
authors.forename: Jaime
authors.initials: J
authors.lastname: Landman
mesh_terms: D000704:Analysis of Variance; D000818:Animals; D001011:Aorta / Q000601:surgery; D004867:Equipment Design; D004869:Equipment Safety; D006488:Hemostasis, Surgical / Q000295:instrumentation*; D023421:Models, Animal; D011336:Probability; D012680:Sensitivity and Specificity; D013525:Surgical Instruments; D013552:Swine; D013718:Tensile Strength; D014656:Vascular Surgical Procedures / Q000295:instrumentation*; D014682:Vena Cava, Inferior / Q000601:surgery