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Research Papers

Bipolar Electrosurgical Vessel-Sealing Device With Compressive Force Monitoring

[+] Author and Article Information
Roland K. Chen

Mem. ASME
Mechanical Engineering,
University of Michigan,
1043E HH Dow,
2300 Hayward Street,
Ann Arbor, MI 48109
e-mail: krchen@umich.edu

Matthew W. Chastagner

Raytheon Company
1151 E Hermans Road,
Tucson, AZ 85756
e-mail: chazz@umich.edu

James D. Geiger

Department of Surgery, Medical School,
University of Michigan,
CS Mott Children's Hospital,
1540 East Hospital Dr, SPC 4211,
Ann Arbor, MI 48109
e-mail: jgeiger@med.umich.edu

Albert J. Shih

ASME Fellow
Mechanical Engineering and
Biomedical Engineering,
University of Michigan,
3001E EECS, 2350 Hayward Street,
Ann Arbor, MI 48109
e-mail: shiha@umich.edu

Manuscript received August 1, 2013; final manuscript received March 7, 2014; accepted manuscript posted March 24, 2014; published online April 18, 2014. Assoc. Editor: Ram Devireddy.

J Biomech Eng 136(6), 061001 (Apr 18, 2014) (7 pages) Paper No: BIO-13-1370; doi: 10.1115/1.4027269 History: Received August 01, 2013; Revised March 07, 2014; Accepted March 24, 2014

Bipolar electrosurgical vessel sealing is commonly used in surgery to perform hemostasis. The electrode compressive force is demonstrably an important factor affecting the vessel seal burst pressure, an index of the seal quality. Using a piezoresistive force sensor attached to the handle of a laparoscopic surgical device, applied handle force was measured and used to predict the electrosurgical vessel compressive force and the pressure at the electrode. The sensor enables the monitoring of vessel compressive force during surgery. Four levels of compressive force were applied to seal three types of porcine vessels (carotid artery, femoral artery, and jugular vein). The burst pressure of the vessel seal was tested to evaluate the seal quality. Compressive pressure was found to be a statistically significant factor affecting burst pressure for femoral arteries and jugular veins. Vessels sealed with low compressive pressure (<300 kPa) have a higher failure rate (burst pressure < 100 mm Hg) than vessels sealed with high compressive pressure. An adequate compressive force is required to generate the compressive pressure needed to form a seal with high burst pressure. A laparoscopic surgical device with compressive force monitoring capability can help ensure adequate compressive pressure, vessel burst pressure, and quality of seal.

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Figures

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Fig. 1

Summary of burst pressure results for different sizes of arteries using commercial bipolar electrosurgical devices: (a) arteries ranging from 2 to 4 mm, (b) arteries ranging from 4 to 6 mm, and (c) arteries ranging from 6 to 8 mm. PK: Gyrus ACMI (Maple Grove, MN) PKS™ Cutting Forceps, RX: SurgRX (Redwood City, CA), EnSeal™ Tissue Sealing, and LS: Valleylab (Boulder, CO) LigaSure™ V.

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Fig. 2

Gyrus ACMI PKS™ cutting forceps (a) overview of device, (b) bipolar electrodes, and (c) compliant mechanism

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Fig. 3

Force sensors (a) attached in the handle to determine the applied handle force and (b) clamped between electrodes to measure the corresponding compressive force

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Fig. 4

Conversion chart for applied handle force to electrode (a) compressive force and (b) compressive pressure for the three types of vessel

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Fig. 5

Handle force and compressive force during the vessel-sealing process of a jugular vein

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Fig. 6

Burst pressure results of four compressive force levels: (a) jugular veins, (b) femoral arteries, and (c) carotid arteries

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Fig. 7

Burst pressure results versus compressive pressure of (a) jugular veins, (b) femoral arteries, and (c) carotid arteries. Marks below the orange lines are considered as failed seals.

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Fig. 8

Failure rate of seals for jugular vein, femoral artery, and carotid artery among four compressive forces. Failure is defined as vessel seal burst pressure less than 100 mm Hg.

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