Tissue response to surgical energy devices.

Area of Science:

• Surgical Innovation
• Biomedical Engineering
• Pathology

Background:

• Limited data exists on the thermal effects of energy-based surgical devices (ESD) on non-vascular tissues.
• Understanding lateral thermal damage is crucial for safe surgical practice.

Purpose of the Study:

• To quantify and compare the lateral thermal damage caused by four contemporary energy-based surgical devices (ESD).
• To evaluate the relationship between blade temperature and tissue damage across different surgical devices.

Main Methods:

• Twenty-four pigs were divided into four groups, each exposed to a specific ESD (Harmonic ACE, Gyrus Trisector, Harmonic LCS-C5, LigaSure V).
• Segments of bladder, stomach, small bowel, colon, ureter, peritoneum, arteries, and veins were tested.
• Tissues were stained and microscopically evaluated for lateral thermal damage; blade temperatures were recorded using thermal imaging.

Main Results:

• The Harmonic ACE (2.4 mm full thickness, 2.8 mm superficial) and LCS-C5 (3.1 mm, 4.3 mm) exhibited the least lateral thermal damage.
• The Gyrus Trisector (6.3 mm, 7.0 mm) and LigaSure V (4.5 mm, 5.9 mm) showed greater thermal spread.
• Blade temperatures varied, with the Trisector lowest (97.84°F) and ACE/LCS-C5 highest (220.5°F/205.6°F).

Conclusions:

• The Harmonic ACE and LCS-C5 demonstrated superior performance with minimal thermal damage to tested tissues.
• Lateral thermal damage from ESD is multifactorial, influenced by blade temperature, transection duration, tissue properties, and vascularity, not solely blade temperature.