Archive




Volume 8, Issue 6, December 2020, Page: 178-183
Intelligent Ultrasonic Energy: New Adaptive Tissue Technology in Harmonic Shears
David Singleton, Department of Medical Affairs, Ethicon, Inc., Blue Ash, Ohio, USA
Natalia Juncosa-Melvin, Department of Preclinical Research, Ethicon, Inc., Blue Ash, Ohio, USA
Patrick Scoggins, Department of Research and Development, Ethicon, Inc., Blue Ash, Ohio, USA
Geisa Paulin-Curlee, Department of Preclinical Research, Ethicon, Inc., Blue Ash, Ohio, USA
John Cummings, Department of Preclinical Research, Ethicon, Inc., Blue Ash, Ohio, USA
Crystal Ricketts, Department of Medical Affairs, Ethicon, Inc., Blue Ash, Ohio, USA
Received: Oct. 6, 2020;       Accepted: Oct. 23, 2020;       Published: Nov. 4, 2020
DOI: 10.11648/j.js.20200806.12      View  51      Downloads  45
Abstract
Objective: Development of ultrasonic technology in surgical devices includes mechanisms of monitoring and adjusting energy delivery to target tissues for the purpose of limiting thermal spread. The objective of the current study was to evaluate performance of a new Adaptive Tissue Technology algorithm, designed to enhance thermal management in the HARMONIC 1100 Shears. Methods: The HARMONIC 1100 Shears were evaluated with bench-top and in vivo preclinical (porcine) analyses for tissue thermal spread, blade heat, transection speed, hemostasis and vessel sealing performance. Testing was performed in parallel with the current production HARMONIC HD 1000i Shears to confirm non-inferiority of the new Adaptive Tissue Technology algorithm. Results: Bench top analysis revealed significantly lower average maximum blade temperatures for HARMONIC 1100 compared to HARMONIC HD 1000i as well as HARMONIC ACE+ 7 Shears with Advanced Hemostasis. Thermal spread, transection speeds, and burst pressure tests of excised porcine carotid arteries did not show a statistical difference between HARMONIC 1100 and HD 1000iShears. In vivo analysis of hemostasis following sealing/transection of various blood vessels in acute porcine testing demonstrated similar efficacy for HARMONIC 1100 and HD 1000i Shears. Likewise, tissue lateral thermal damage showed no statistical difference between the new and previous generation Harmonic device in the porcine model. Conclusion: The new Adaptive Tissue Technology in HARMONIC 1100 Shears allows for reduced maximum blade temperatures while providing effective hemostasis, sealing strength, transection speed, and limited thermal damage.
Keywords
Ultrasonic, Harmonic, Laparoscopy, Tissue Sealing, Hemostasis
To cite this article
David Singleton, Natalia Juncosa-Melvin, Patrick Scoggins, Geisa Paulin-Curlee, John Cummings, Crystal Ricketts, Intelligent Ultrasonic Energy: New Adaptive Tissue Technology in Harmonic Shears, Journal of Surgery. Vol. 8, No. 6, 2020, pp. 178-183. doi: 10.11648/j.js.20200806.12
Copyright
Copyright © 2020 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Reference
[1]
Devassy R, Gopalakrishnan S, De Wilde RL. Surgical Efficacy Among Laparoscopic Ultrasonic Dissectors: Are We Advancing Safely? A Review of Literature. J Obstet Gynaecol India 2015; 65: 293-300.
[2]
Law KS, Abbott JA, Lyons SD. Energy sources for gynecologic laparoscopic surgery: a review of the literature. Obstet Gynecol Surv 2014; 69: 763-76.
[3]
Lyons SD, Law KS. Laparoscopic vessel sealing technologies. J Minim Invasive Gynecol 2013; 20: 301-7.
[4]
Wang K, Advincula AP. "Current thoughts" in electrosurgery. International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics 2007; 97: 245-50.
[5]
Cannizzaro MA, Borzi L, Lo Bianco S, Okatyeva V, Cavallaro A, Buffone A. Comparison between Focus Harmonic scalpel and other hemostatic techniques in open thyroidectomy: A systematic review and meta-analysis. Head and Neck 2016; 38 (10): 1571-8.
[6]
Cheng H, Hsiao CW, Clymer JW, et al. Gastrectomy and D2 Lymphadenectomy for Gastric Cancer: A Meta-Analysis Comparing the Harmonic Scalpel to Conventional Techniques. Int J Surg Oncol 2015; 2015: 397260.
[7]
Ren ZH, Xu JL, Fan TF, Ji T, Wu HJ, Zhang CP. The Harmonic Scalpel versus Conventional Hemostasis for Neck Dissection: A Meta-Analysis of the Randomized Controlled Trials. PLoS One 2015; 10: e0132476.
[8]
Revelli L, Damiani G, Bianchi CB, et al. Complications in thyroid surgery. Harmonic Scalpel, Harmonic Focus versus Conventional Hemostasis: A meta-analysis. International journal of surgery 2016; 28 Suppl 1: S22-32.
[9]
Cheng H, Clymer JW, Ferko NC, et al. A systematic review and meta-analysis of Harmonic technology compared with conventional techniques in mastectomy and breast-conserving surgery with lymphadenectomy for breast cancer. Breast Cancer (Dove Med Press) 2016; 8: 125-40.
[10]
Cheng H, Soleas IM, Ferko NC, Cameron CG, Clymer JW, Amaral JF. Hospital costs associated with thyroidectomy performed with a Harmonic device compared to conventional techniques: a systematic review and meta-analysis. Journal of Medical Economics 2016; 19 (8): 750-8.
[11]
Zhang ZJ, Zhang P, Tian JH, et al. Ultrasonic coagulator for thyroidectomy: a systematic review of randomized controlled trials. Surgical innovation 2010; 17: 41-7.
[12]
Casadei R, Ricci C, Pacilio CA, Ingaldi C, Taffurelli G, Minni F. Laparoscopic distal pancreatectomy: which factors are related to open conversion? Lessons learned from 68 consecutive procedures in a high-volume pancreatic center. Surg Endosc 2018; 32: 3839-45.
[13]
Kim KJ, Chung JH, Lee HC, Lee BI, Park SH, Yoon ES. Comparison of Harmonic scalpel and monopolar cautery for capsulectomy at the second stage of expander/implant breast reconstruction. Arch Plast Surg 2020; 47: 140-5.
[14]
McCarus SD. McCarus Minimally Invasive Hysterectomy: 20 Years' Experience-Lessons Learned. Surgical technology international 2018; 33: 207-14.
[15]
Otsuka K, Murakami M, Goto S, et al. Minimally invasive esophagectomy and radical lymph node dissection without recurrent laryngeal nerve paralysis. Surg Endosc 2020; 34: 2749-57.
Browse journals by subject