HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Daniel G. Nicastri Jaime Yun Scott J. Swanson Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Nicastri, D. G. Articles by Swanson, S. J. Search for Related Content PubMed PubMed Citation Articles by Nicastri, D. G. Articles by Swanson, S. J. Related Collections Minimally invasive surgery

J Thorac Cardiovasc Surg 2007;134:160-164
© 2007 The American Association for Thoracic Surgery

Evolving Technology

Evaluation of efficacy of an ultrasonic scalpel for pulmonary vascular ligation in an animal model

^a Department of Surgery, Mount Sinai Medical Center, New York, NY
^b Department of Pathology, Mount Sinai Medical Center, New York, NY
^c Department of Thoracic Surgery, Mount Sinai Medical Center, New York, NY.

Received for publication November 28, 2006; revisions received February 7, 2007; accepted for publication February 12, 2007.

^_* Address for reprints: Scott J. Swanson, MD, Mount Sinai Medical Center, 1190 Fifth Avenue, New York, NY 10029. (Email: scott.swanson{at}mountsinai.org).

Objective: Dissection to accommodate bulky stapling devices may cause injury to pulmonary arteries in thoracoscopic lobectomies. The Harmonic Ace (Ethicon Endo-Surgery, Inc; Cincinnati, Ohio), a small ultrasonic scalpel used in systemic vessels, was tested on pulmonary vessels in pigs.

Methods: Nine pigs were assigned 1- or 6-week survival. Lobectomies were performed using the device to divide and ligate pulmonary vessels. Vessel diameter was measured, and ligation outcome was recorded. Necropsies were then performed.

Results: Permanent ligation occurred in 76% of arteries and 92% of veins. At the highest power setting, the instrument showed no failure in arteries 5 mm or less and veins 7 mm or less. Necropsies revealed no evidence of postoperative bleeding. Histopathologic analysis revealed acute coagulation necrosis at 1 week. By 6 weeks, the vessel stumps displayed features consistent with normal wound healing.

Conclusions: This device reliably divides pulmonary vessels 4 mm and smaller, typically encountered in pig lobectomies. Higher power settings and operator experience may increase effectiveness. Further testing is necessary to delineate the device’s limitations before potential use in human pulmonary vasculature.

This article has been cited by other articles:

				H. Nakayama, H. Ito, Y. Kato, and M. Tsuboi Ultrasonic scalpel for sealing of the thoracic duct: evaluation of effectiveness in an animal model Interact CardioVasc Thorac Surg, September 1, 2009; 9(3): 399 - 401. [Abstract] [Full Text] [PDF]

				T. Tanaka, K. Ueda, M. Hayashi, and K. Hamano Clinical application of an ultrasonic scalpel to divide pulmonary vessels based on laboratory evidence Interact CardioVasc Thorac Surg, June 1, 2009; 8(6): 615 - 618. [Abstract] [Full Text] [PDF]