Development of a 23.5 kHz ultrasonically activated device for laparoscopic surgery

Summary

We tested, in an animal model, a newly developed ultrasonically activated device for laparoscopic use. Porcine arteries, with a diameter of 3 mm, were successfully coagulated and divided using this device. 11 segments of treated arteries were harvested and the pressure needed to burst the stump was measured in vitro. The maximum pressure required to burst the stump of an artery ranged from 353 to 2126 mmHg, with an average of 1121 mmHg. These data suggest that the arteries divided by the new device can withstand the intraluminal pressure of arteries in living animals. For a first clinical experience, we used this device in laparoscopic splenectomy, on a patient with idiopathic thrombocytopenic purpura. The short gastric vessels and branches of the main splenic vessels could be occluded and divided by the device without a clip. The main splenic vessels were cut using a stapler. The operation took 80 min, with a blood loss of ≤ 10 ml. Post-operative bleeding did not occur. The new, ultrasonically-activated device is a reliable instrument for occluding and dividing vessels of relatively small caliber. We conclude that this device is useful for a speedy and safe dissection of the tissue during laparoscopic surgery.

Keywords:

• ultrasonically activated device
• tissue dissection
• laparoscopic surgery
• vessel coagulation
• vessel dissection