Background: Although energy devices have brought big advantages to surgery, there are few reports about disadvantages. We conducted an animal experiment to clarify the thermal effect of the bipolar tissue sealing system, Enseal™, to adjacent vessels of the inferior vena cava.
Methods: We used an experimental miniature pig for the experiment. After laparotomy and mobilization of the intestine, the inferior vena cava was exposed. We activated the device under two different conditions: In the first group, the so-called contact group (Group C), the blade of Enseal™ touched the surface of the IVC directly. In the other group, referred to as non-contact group (Group N), the blade was held about 1 mm away from the IVC. Activation time of the generator was 5, 10, and 15 s, respectively, in both groups.
Results: In Group C, the mean IVC surface temperature was 47.2, 57.6, and 60.4 °C for 5, 10, and 15 s, respectively. The difference between the mean temperature of 5 and 15 s is statistically significant. In Group N, no statistical significance was achieved in all time-settings. The muscular layers of the IVC wall in Group C after 10 s of activation were broken, and cell nuclei were shrunken.
Conclusions: When Enseal™ is used, contact with the adjacent vessels of the IVC should be avoided at all. It could increase the risk of heat injury to the vessel wall.
Keywords: Bipolar tissue sealer; Heat injury; Instruments; Technical.