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Laparoscopic Bowel Resection: A Comparison of Three Ultrasonically Activated Devices

BACKGROUND AND OBJECTIVES: To compare resection time and collateral thermal damage of 3 currently available ultrasonically activated devices in laparoscopic small bowel surgery. METHODS: AutoSonix®, SonoSurg®, and UltraCision® were compared in laparoscopic small bowel mesentery resection in a porcin...

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Autores principales: Bergamaschi, Roberto, Yavuz, Yunus, Marvik, Ronald
Formato: Texto
Lenguaje:English
Publicado: Society of Laparoendoscopic Surgeons 2003
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3015463/
https://www.ncbi.nlm.nih.gov/pubmed/12722994
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author Bergamaschi, Roberto
Yavuz, Yunus
Marvik, Ronald
author_facet Bergamaschi, Roberto
Yavuz, Yunus
Marvik, Ronald
author_sort Bergamaschi, Roberto
collection PubMed
description BACKGROUND AND OBJECTIVES: To compare resection time and collateral thermal damage of 3 currently available ultrasonically activated devices in laparoscopic small bowel surgery. METHODS: AutoSonix®, SonoSurg®, and UltraCision® were compared in laparoscopic small bowel mesentery resection in a porcine model. A resection was defined as 12 endarcade arteries supplying the intended bowel segment. Vessels were divided 1 cm off the bowel wall. AutoSonix®, SonoSurg®, and UltraCision® were comparable for blade length and type, cutting mechanism, handle ergonomics, and vibration amplitude, but not well matched for vibration frequency (55.5;23.5;55.5 kHz), working shaft diameter (5;11;10mm) and length (29;33;34cm), respectively. A sample size of 114 was calculated to detect a 25% difference with 90% power at a 5% significance level. Resections were allocated to devices by block randomization. Analysis of variance and pairwise Scheffe tests were used for multiple comparisons, and a Kaplan-Meier plot was drawn to confirm differences in resection time with each device. A pathologist blind to the devices evaluated bowel wall biopsies for thermal damage. RESULTS: Procedures as allocated comprised 114 resections (38 with each device). UltraCision® median resection time of 5160 (range 2340-7860) seconds was significantly longer (P=0.0001). The difference in resection time between AutoSonix® (median 3420, range 1860-8760 s) and SonoSurg® (median 3660, range 1800-6900 s) did not reach statistical significance. A microscopy revealed no thermal damage. CONCLUSIONS: Laparoscopic resection time for porcine bowel mesentery was shorter with AutoSonix® or SonoSurg® than with UltraCision®, and no thermal damage to the bowel wall was found.
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spelling pubmed-30154632011-02-17 Laparoscopic Bowel Resection: A Comparison of Three Ultrasonically Activated Devices Bergamaschi, Roberto Yavuz, Yunus Marvik, Ronald JSLS Scientific Papers BACKGROUND AND OBJECTIVES: To compare resection time and collateral thermal damage of 3 currently available ultrasonically activated devices in laparoscopic small bowel surgery. METHODS: AutoSonix®, SonoSurg®, and UltraCision® were compared in laparoscopic small bowel mesentery resection in a porcine model. A resection was defined as 12 endarcade arteries supplying the intended bowel segment. Vessels were divided 1 cm off the bowel wall. AutoSonix®, SonoSurg®, and UltraCision® were comparable for blade length and type, cutting mechanism, handle ergonomics, and vibration amplitude, but not well matched for vibration frequency (55.5;23.5;55.5 kHz), working shaft diameter (5;11;10mm) and length (29;33;34cm), respectively. A sample size of 114 was calculated to detect a 25% difference with 90% power at a 5% significance level. Resections were allocated to devices by block randomization. Analysis of variance and pairwise Scheffe tests were used for multiple comparisons, and a Kaplan-Meier plot was drawn to confirm differences in resection time with each device. A pathologist blind to the devices evaluated bowel wall biopsies for thermal damage. RESULTS: Procedures as allocated comprised 114 resections (38 with each device). UltraCision® median resection time of 5160 (range 2340-7860) seconds was significantly longer (P=0.0001). The difference in resection time between AutoSonix® (median 3420, range 1860-8760 s) and SonoSurg® (median 3660, range 1800-6900 s) did not reach statistical significance. A microscopy revealed no thermal damage. CONCLUSIONS: Laparoscopic resection time for porcine bowel mesentery was shorter with AutoSonix® or SonoSurg® than with UltraCision®, and no thermal damage to the bowel wall was found. Society of Laparoendoscopic Surgeons 2003 /pmc/articles/PMC3015463/ /pubmed/12722994 Text en © 2003 by JSLS, Journal of the Society of Laparoendoscopic Surgeons. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives License (http://creativecommons.org/licenses/by-nc-nd/3.0/), which permits for noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited and is not altered in any way.
spellingShingle Scientific Papers
Bergamaschi, Roberto
Yavuz, Yunus
Marvik, Ronald
Laparoscopic Bowel Resection: A Comparison of Three Ultrasonically Activated Devices
title Laparoscopic Bowel Resection: A Comparison of Three Ultrasonically Activated Devices
title_full Laparoscopic Bowel Resection: A Comparison of Three Ultrasonically Activated Devices
title_fullStr Laparoscopic Bowel Resection: A Comparison of Three Ultrasonically Activated Devices
title_full_unstemmed Laparoscopic Bowel Resection: A Comparison of Three Ultrasonically Activated Devices
title_short Laparoscopic Bowel Resection: A Comparison of Three Ultrasonically Activated Devices
title_sort laparoscopic bowel resection: a comparison of three ultrasonically activated devices
topic Scientific Papers
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3015463/
https://www.ncbi.nlm.nih.gov/pubmed/12722994
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