title: A comparison of laparoscopic energy devices on charges in thermal power after application to porcine mesentery.
abstract: BACKGROUND
  Advances in energy devices have played a major role in the rapid expansion of laparoscopic surgery. However, complications due to these energy devices are occasionally reported, and if the characteristics of these devices are not well understood, serious complications may occur. This study evaluated various typical energy devices and measured temperature rises in the adjacent tissue and in the devices themselves.
  
  
  METHODS
  We used the following 7 types of energy devices: AutoSonix (AU), SonoSurg (SS), Harmonic Scalpel (HS), LigaSure Atlas (LA), LigaSure Dolphin Tip (LD), monopolar diathermy (Mono), and bipolar scissors (Bi). Laparoscopy was performed under general anesthesia in pigs, and the mesentery was dissected using each energy device. Tissue temperature at a distance of 1 mm from the energy device blade before and after dissection was measured. Temperature of the device blade both before and after dissection, time required for dissection, and interval until the temperature fell to 100°C, 75°C, and 50°C were documented.
  
  
  RESULTS
  Temperature of the surrounding tissue using each device rose the most with the Mono (50.5±8.0°C) and the least with the HS in full mode (6.2±0.7°C). Device temperature itself rose the highest with the AU in full mode (318.2±49.6°C), and the least with the Bi (61.9±4.8°C). All ultrasonic coagulation and cutting devices (AU, SS, and HS) had device temperatures increase up to ≥100°C, and even at 8 seconds after completing dissection, temperatures remained at ≥100°C.
  
  
  CONCLUSIONS
  Because the adjacent tissue temperature peaked with the Mono, cautious use near the intestine and blood vessels is necessary. In addition, the active blades of all ultrasonic coagulation and cutting devices, regardless of model, developed high temperatures exceeding 100°C. Therefore, an adequate cooling period after using these devices is therefore necessary between applications.
authors: Department of Surgery, Jikei University School of Medicine, Minato-ku, Tokyo, Japan.
authors: Ken
authors: K
authors: Eto
authors: Nobuo
authors: N
authors: Omura
authors: Koichiro
authors: K
authors: Haruki
authors: Yoshiko
authors: Y
authors: Uno
authors: Masahisa
authors: M
authors: Ohkuma
authors: Shintaro
authors: S
authors: Nakajima
authors: Tadashi
authors: T
authors: Anan
authors: Makoto
authors: M
authors: Kosuge
authors: Tetsuji
authors: T
authors: Fujita
authors: Katsuhiko
authors: K
authors: Yanaga
mesh_terms: D000818:Animals; D001831:Body Temperature / Q000528:radiation effects*; D004210:Dissection / Q000295:instrumentation; D004564:Electrocoagulation / Q000295:instrumentation*; D004598:Electrosurgery / Q000295:instrumentation*; D010535:Laparoscopy / Q000295:instrumentation*; D008643:Mesentery / Q000528:radiation effects* / Q000601:surgery; D013552:Swine; D013696:Temperature; D059708:Ultrasonic Surgical Procedures / Q000295:instrumentation*
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