title: Comparative Study of Performance in Ultrasonic Tissue Dissection for Sleeve Gastrectomy: Wired versus Cordless.
abstract: BACKGROUND
  The sleeve gastrectomy is being performed increasingly as a primary procedure for the treatment of morbid obesity. A minimally invasive approach is currently applied to the procedure. The two major steps are dissection and stapling. For dissection, several tools have been developed. The goal of this study was to compare the efficiency and the ergonomics of two ultrasonic devices during the sleeve gastrectomy.
  
  
  METHODS
  Thirty patients were randomised for the use of a cordless Sonicision™ (Covidien, Mansfield, MA) or a cord-containing HARMONIC ACE®+ (Ethicon Endo-Surgery Inc., Cincinnati, OH) during dissection. Both devices were assessed for objective and subjective measures.
  
  
  RESULTS
  There was no significant difference in duration of the procedures. The assembly and installation time of the Sonicision™ were significantly shorter; however, the dismantle time was not. No difference in plume formation or dissection failures was found between the devices. Scrub nurses scored the Sonicision™ significantly clearer and easier in use and more reliable. The surgeons, however, did not find one of the devices easier in use, more reliable or precise, but they did report better manoeuvrability of the Sonicision™.
  
  
  CONCLUSIONS
  In comparison to the wired HARMONIC ACE®+, during sleeve gastrectomy, the cordless Sonicision™ was considered easier to use, faster during assembling and installation, and more reliable with better manoeuvrability. Surgeons scored both devices equally effective. Both ultrasonic devices can be used easily and safely for a sleeve gastrectomy.
authors.affiliation: Department of Surgery, Catharina Hospital, Eindhoven, The Netherlands.
authors.forename: Pim W J
authors.initials: PW
authors.lastname: van Rutte
authors.affiliation: Faculty of Industrial Design Engineering, Technical University of Delft, Delft, The Netherlands.
authors.forename: Sandra L
authors.initials: SL
authors.lastname: Lup
authors.affiliation: Surgical Department, Catharina Hospital, Eindhoven, The Netherlands.
authors.forename: Misha D
authors.initials: MD
authors.lastname: Luyer
authors.affiliation: Faculty of Industrial Design Engineering, Technical University of Delft, Delft, The Netherlands.
authors.forename: Jack J
authors.initials: JJ
authors.lastname: Jakimowicz
authors.affiliation: Faculty of Industrial Design Engineering, Technical University of Delft, Delft, The Netherlands.
authors.forename: Richard H M
authors.initials: RH
authors.lastname: Goossens
authors.affiliation: Surgical Department, Catharina Hospital, Eindhoven, The Netherlands.
authors.forename: Simon W
authors.initials: SW
authors.lastname: Nienhuijs
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D004210:Dissection / Q000295:instrumentation*; D011211:Electric Power Supplies; D004867:Equipment Design; D019544:Equipment Failure Analysis; D006804:Ergonomics / Q000295:instrumentation; D005260:Female; D005743:Gastrectomy / Q000295:instrumentation*; D006801:Humans; D008297:Male; D019060:Minimally Invasive Surgical Procedures / Q000295:instrumentation*; D061646:Operative Time; D016896:Treatment Outcome; D059708:Ultrasonic Surgical Procedures / Q000295:instrumentation*