BioScience Trends. 2018;12(1):60-67. (DOI: 10.5582/bst.2017.01308)
Safety and feasibility of a novel non-thermal device for tissue dissection: A preliminary study of the DD1 differential dissector.
Yoshida N, Yamazaki S, Sugitani M, Takayama T
Energy devices can cause significant thermal damage to surrounding tissues causing unanticipated organ trauma. To evaluate the safety and feasibility of a novel electric device (DD1) for soft tissue dissection. Three series of measurements were performed in a pig model. First, macro- and microscopic tissue damage was compared between the DD1 and an electric scalpel (ES). Second, the time course of tissue temperature was measured for the DD1 and three other energy devices (ES, Harmonic and LigaSure). Third, the time required for mobilization of a peripheral artery of the intestine was compared between the DD1 and manual, non-energized forceps. First, the tissue damage area caused by ES was significantly larger compared to that in the DD1 at all time points (p < 0.0001). The number of damaged cells due to thermal damage was significantly larger for ES than for DD1, even when the DD1 was applied to a single point at maximum power for 60 sec (p < 0.0001). Second, the maximum temperature of Harmonic was 160ï¿½C 3 sec after use and dropped to 68ï¿½C after 10 sec. At the same time points after use, we observed: ES (84ï¿½C, 45ï¿½C), LigaSure (61ï¿½C, 49ï¿½C), and DD1 (30.5ï¿½C, 29ï¿½C). Third, the median dissection time for the artery using DD1 was significantly shorter than that for dissecting forceps (DD1: 100 sec, range 70-205 sec vs. forceps: 130 sec, range 90-210 sec, p = 0.0325). DD1 was a safe non-thermal device which causes less tissue damage while also providing shorter dissection times than manual dissection.