[Ultrasonically activated coagulating shears and the vessel sealing system in thoracic surgery]

While the recent emergence of energy-based surgical techniques has made surgical procedures less invasive, the safety and proper usage have yet to be investigated. Here we review the experimental and clinical use of ultrasonically activated coagulating shears and a vessel sealing system in thoracic surgery. Both energy devices have been reported to be safe for use with the pulmonary artery and vein, with a burst pressure above 100 mmHg. Although their combined use with a ligature at a central site appeared to be adequate, the long-term durability has yet to be verified. The thoracic duct was reported to be sealed with sufficient burst pressure using these energy devices, which are expected to provide an alternative treatment for chylothorax. There have also been a few reports of their usage with the lung parenchyma, but their clinical adaptation is seemingly limited.