Evaluation of the Power Generated by Ultrasonic Shears Used in Laparoscopic Surgeries

Abstract

Minimally invasive surgical procedures are in evidence and are, therefore, the major worldwide trend. They correspond to a great technological advance that aims to promote patient safety, minimizing complications and making possible some complex surgeries that were not possible to be performed in the past. Highly complex surgeries require the use of equipment that presents high precision in cutting biological tissues and that is also combined with cauterization, thus avoiding complications caused by hemorrhages and even infections. The objective of this work was to evaluate the power/intensity generated by ultrasonic shears used in surgical procedures. Twenty-five Harmonic Ace® shears—HAR36 were evaluated, with four handpieces coupled to eight different ETHICON GEN11 generators. The generators were configured to generate the Level 5 power, standard for cutting, Level 3, standard for coagulation and Level 1, also used for coagulation with greater efficiency. For each GEN11 configuration, the maximum generated power values were measured using an Ohmic Instruments UPM-DT-1 Ultrasound Power Meter. The expected value and standard deviations were calculated using EXCEL (Microsoft Corp.). The average powers generated for all evaluated devices were 1.08 ± 0.80 W for Level 1, 3.74 ± 2.28 W for Level 3 and 9.18 ± 3.32 W for Level 5. It was found that there is a 20-fold variation between the lowest and the highest power generated, showing the importance of implementing an adequate quality control protocol for these devices. It was also found that, even during the standard test of equipment, high levels of intensity are generated that can subject operators to risks if they do not take proper care, requiring adequate training of these professionals. Thus, to avoid risks to operators, this work suggests a safety protocol with the steps to be followed when activating the ultrasonic shears.