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Initial results with an electrothermal bipolar vessel sealer.
B T Heniford1, B D Matthews, R F Sing
1Carolinas Laparoscopic and Advanced Surgery Program, Department of General Surgery, Carolinas Medical Center, 1000 Blythe Boulevard, MEB # 601, Charlotte, NC, USA.
Surgical Endoscopy
|July 10, 2001
Summary
The electrothermal bipolar vessel sealer (EBVS) is safe and effective for vessel ligation in open and laparoscopic surgery. This instrument significantly reduces operative time in open procedures and is faster than traditional ligatures in animal models.
Area of Science:
- Surgical Technology
- Vascular Surgery
- Minimally Invasive Surgery
Background:
- The electrothermal bipolar vessel sealer (EBVS) was developed as an alternative to traditional ligation methods like suture ligatures, hemoclips, staplers, and ultrasonic coagulators.
- The EBVS functions by denaturing collagen and elastin to seal vessels up to 7 mm in diameter.
- This study aimed to assess the clinical efficacy, safety, and time-saving potential of the EBVS in both experimental and clinical settings.
Purpose of the Study:
- To evaluate the clinical efficacy and safety of the electrothermal bipolar vessel sealer (EBVS).
- To determine the potential time savings associated with using the EBVS in surgical procedures.
- To compare the performance of the EBVS against traditional ligation methods in an animal model.
Main Methods:
- A prospective review of clinical cases using the EBVS in open and laparoscopic surgeries from October 1998 to March 2000.
- An animal study involving small intestine resections in pigs, comparing the EBVS with suture ligatures.
- Key measurements included operative time, application rate, and incidence of post-application bleeding, with statistical analysis using Student's t-test.
Main Results:
- The EBVS was utilized in 98 cases (46 laparoscopic, 52 open) with a mean of 43 applications per case.
- Alternative ligation was required in only 0.3% of EBVS applications, with no postoperative hemorrhagic complications.
- Open procedures showed an estimated mean reduction in operative time of 39 minutes; laparoscopic procedures had a mean increase of 8 minutes. In animal models, EBVS was significantly faster (251.9s vs 702.0s) and more efficient (7.6 vs 1.8 applications/min) than ligatures (p < 0.001).
Conclusions:
- The EBVS is a safe and effective instrument for vessel ligation in both open and laparoscopic surgery.
- The EBVS demonstrates a significant reduction in operative time for open procedures.
- In an animal model, the EBVS proved significantly faster and more efficient for intestinal resection compared to traditional ligatures.