Surgical techniques using low-power monopolar scissors in robotic-assisted thoracic surgery

Area of Science:

• Surgical Technology
• Electrosurgery
• Robotic Surgery

Background:

• Monopolar soft coagulation is a standard surgical technique.
• The da Vinci system offers advanced robotic-assisted surgical capabilities.
• Evaluating alternative energy modes is crucial for optimizing surgical procedures.

Purpose of the Study:

• To assess the electrical characteristics of the da Vinci system's low-power monopolar coagulation mode.
• To determine its efficacy and safety as a substitute for monopolar soft coagulation.
• To validate its performance in robotic-assisted surgical applications.

Main Methods:

• Electrical analysis using an electrocautery analyzer to measure voltage and power.
• Ex vivo testing with chicken meat and infrared thermography to assess thermal effects.
• Clinical evaluation during 73 robotic-assisted lung resections.

Main Results:

• The low-power forced coagulation mode exhibited voltage plateaus comparable to soft coagulation modes.
• Ex vivo tests showed no carbonization below 90°C, indicating safety.
• Clinical application in lung resections demonstrated no adverse events like sparks or carbonization, with results similar to soft coagulation.

Conclusions:

• The da Vinci system's forced coagulation mode is a viable alternative to monopolar soft coagulation.
• Appropriate selection of effect and power limit settings ensures comparable surgical outcomes.
• This finding supports the expanded use of the da Vinci system's energy modalities.