A NEW THERMAL DEVICE FOR SEALING AND DIVIDING BLOOD VESSELS

Background: The limitations and hazards of monopolar electrosurgical instruments in laparoscopic surgery are well known. Bipolar and ultrasonic instruments address these problems but may be less than ideal in certain applications. A new type of instrument is described which produces effective coagulation and division with extremely little collateral tissue damage. These instruments use direct thermal energy and simultaneous pressure to sequentially denature, bond and then cut protein based tissue structures. Because of the underlying technical simplicity, these new instruments could be very cost effective. The mode of action and tissue effects are described and contrasted to monopolar and bipolar electrosurgical and ultrasonic devices. Methods: In a porcine mesenteric vessel model, collateral thermal damage and blood vessel bursting strength were made Results: The new instruments appear capable of producing effective tissue sealing with bursting pressures over 300 mmHg and with minimal collateral damage of less than 1 mm. Conclusions: This cost effective direct thermal technology may be a useful alternative to existing coagulating and cutting modalities, particularly in applications where minimizing collateral damage is important