[Dissection technique--is ultrasound the best method?].

Area of Science:

• Minimally Invasive Surgery
• Surgical Technology
• Vascular Surgery

Background:

• Preventive hemostasis is critical in endoscopic surgery to minimize bleeding and ensure patient safety.
• Ultrasonic dissectors are widely employed surgical tools for tissue dissection and hemostasis.
• Evaluating the safety and efficacy of hemostatic devices is essential for advancing surgical techniques.

Purpose of the Study:

• To assess the occlusion safety of bipolar forceps and ultrasonic dissectors in porcine vessels.
• To quantify the thermal effects and lateral tissue damage associated with ultrasonic dissector use.
• To compare the safety profiles of two common hemostatic tools in endoscopic procedures.

Main Methods:

• Porcine vessels were used to simulate human vasculature for testing.
• Occlusion safety was evaluated for both bipolar forceps and ultrasonic dissectors.
• Thermographic imaging was utilized to record tissue temperatures during device activation.
• In vivo and in vitro measurements quantified the lateral damage zone.

Main Results:

• Ultrasonic dissectors generated maximum temperatures reaching up to 200°C.
• The lateral damage zone caused by the ultrasonic dissector ranged from 2 to 6 mm.
• Bipolar forceps demonstrated adequate occlusion safety (specific data not detailed in abstract).

Conclusions:

• Ultrasonic dissectors pose a risk of significant thermal injury due to high temperatures and lateral damage.
• Careful consideration of device selection and application technique is necessary for safe hemostasis.
• Further research may be needed to optimize ultrasonic dissector technology for reduced thermal spread.