Functional Evaluation of a Novel Microwave Surgical Device in a Canine Splenectomy Model.

Aim: Partial splenectomy remains a difficult procedure even with the assistance of a sealing system. Recently, a scissor-like microwave energy device (Acrosurg) that provides seamless coagulation and manual cutting has been applied in surgery. The objective of this study is to evaluate the surgical capabilities of Acrosurg in partial splenectomy. Materials and

Methods

Acrosurg and Harmonic Focus (HF) were employed for partial splenectomy in dogs without prior ligation of vessels. Cutting time, cutting area, and bleeding were recorded. Lateral thermal injury (LTI), possible complications was observed immediately and after 4 weeks.

Results

The manual cutting mechanism of Acrosurg required a longer cutting time compared with the automatic cutting mode of HF (301.5 [243.2-527] vs. 114.5 [106.0-135.0] sec, p < 0.01). There was no statistical difference in cutting area or bleeding cases. Acrosurg achieved complete hemostasis in all cases, whereas the HF group failed to stop bleeding in two of the eight cases. The Acrosurg group exhibited a similar LTI compared with the HF group (3.0 [2.4-3.4] vs. 2.7 [2.3-2.9] mm, p = 0.151), but the LTI of the Acrosurg group tended to shrink more after 4 weeks (1.2 [1.0-1.3] vs. 1.7 [1.3-1.9] mm, p < 0.05).

Conclusions

A microwave energy device enabled a partial splenectomy without vessel ligation. The combination of manual cutting and sealing capability helps not only provide an appropriate seal time by adjusting cutting timing adaptively but also potentially stop bleeding by using a microwave heating process unlike other energy devices.