Hemostasis with the Ultrasonic Scalpel

Area of Science:

• Surgical Technology
• Minimally Invasive Surgery
• Vascular Surgery

Background:

• The ultrasonic scalpel is a key instrument in minimally invasive surgery for vessel sealing.
• Assessing its safety and efficacy in sealing various vessel sizes under different blood pressure conditions is crucial.

Purpose of the Study:

• To evaluate the safety and feasibility of a laparoscopic ultrasonic scalpel.
• To determine the maximum vessel diameter safely sealed by the instrument in vivo.
• To assess performance under both physiological and supraphysiological blood pressure.

Main Methods:

• A single healthy female swine underwent omentum resection, liver biopsies, and hysterectomy.
• Vessels ranging from 2 to 10 mm were sealed using the ultrasonic scalpel.
• Procedures were conducted under normal hemodynamics and during pharmacologically induced hypertension.

Main Results:

• The ultrasonic scalpel was effective and rapid, with no bleeding in resected tissues.
• Vessels up to 8 mm were sealed without bleeding, even during sustained high blood pressure challenges.
• Bleeding occurred in one 10 mm common iliac vein and one 10 mm common iliac artery during testing.

Conclusions:

• The ultrasonic scalpel demonstrates safety in sealing arteries up to 8 mm during laparoscopic procedures.
• It effectively prevents or controls bleeding, even when blood pressure is elevated.
• The instrument shows high feasibility for use in complex laparoscopic surgeries.