Intelligent Ultrasonic Energy: New Adaptive Tissue Technology in Harmonic Shears

David Singleton; Natalia Juncosa-Melvin; Patrick Scoggins; Geisa Paulin-Curlee; John Cummings; Crystal Ricketts

doi:doi:10.11648/j.js.20200806.12

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Intelligent Ultrasonic Energy: New Adaptive Tissue Technology in Harmonic Shears

David Singleton, Natalia Juncosa-Melvin, Patrick Scoggins, Geisa Paulin-Curlee, John Cummings, Crystal Ricketts

Published in Journal of Surgery (Volume 8, Issue 6)

Received: 6 October 2020 Accepted: 23 October 2020 Published: 4 November 2020

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Abstract

Objective: Development of ultrasonic technology in surgical devices includes mechanisms of monitoring and adjusting energy delivery to target tissues for the purpose of limiting thermal spread. The objective of the current study was to evaluate performance of a new Adaptive Tissue Technology algorithm, designed to enhance thermal management in the HARMONIC 1100 Shears. Methods: The HARMONIC 1100 Shears were evaluated with bench-top and in vivo preclinical (porcine) analyses for tissue thermal spread, blade heat, transection speed, hemostasis and vessel sealing performance. Testing was performed in parallel with the current production HARMONIC HD 1000i Shears to confirm non-inferiority of the new Adaptive Tissue Technology algorithm. Results: Bench top analysis revealed significantly lower average maximum blade temperatures for HARMONIC 1100 compared to HARMONIC HD 1000i as well as HARMONIC ACE+ 7 Shears with Advanced Hemostasis. Thermal spread, transection speeds, and burst pressure tests of excised porcine carotid arteries did not show a statistical difference between HARMONIC 1100 and HD 1000iShears. In vivo analysis of hemostasis following sealing/transection of various blood vessels in acute porcine testing demonstrated similar efficacy for HARMONIC 1100 and HD 1000i Shears. Likewise, tissue lateral thermal damage showed no statistical difference between the new and previous generation Harmonic device in the porcine model. Conclusion: The new Adaptive Tissue Technology in HARMONIC 1100 Shears allows for reduced maximum blade temperatures while providing effective hemostasis, sealing strength, transection speed, and limited thermal damage.

Published in	Journal of Surgery (Volume 8, Issue 6)
DOI	10.11648/j.js.20200806.12
Page(s)	178-183
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2020. Published by Science Publishing Group

Keywords

Ultrasonic, Harmonic, Laparoscopy, Tissue Sealing, Hemostasis

References

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[4]	Wang K, Advincula AP. "Current thoughts" in electrosurgery. International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics 2007; 97: 245-50.
[5]	Cannizzaro MA, Borzi L, Lo Bianco S, Okatyeva V, Cavallaro A, Buffone A. Comparison between Focus Harmonic scalpel and other hemostatic techniques in open thyroidectomy: A systematic review and meta-analysis. Head and Neck 2016; 38 (10): 1571-8.
[6]	Cheng H, Hsiao CW, Clymer JW, et al. Gastrectomy and D2 Lymphadenectomy for Gastric Cancer: A Meta-Analysis Comparing the Harmonic Scalpel to Conventional Techniques. Int J Surg Oncol 2015; 2015: 397260.
[7]	Ren ZH, Xu JL, Fan TF, Ji T, Wu HJ, Zhang CP. The Harmonic Scalpel versus Conventional Hemostasis for Neck Dissection: A Meta-Analysis of the Randomized Controlled Trials. PLoS One 2015; 10: e0132476.
[8]	Revelli L, Damiani G, Bianchi CB, et al. Complications in thyroid surgery. Harmonic Scalpel, Harmonic Focus versus Conventional Hemostasis: A meta-analysis. International journal of surgery 2016; 28 Suppl 1: S22-32.
[9]	Cheng H, Clymer JW, Ferko NC, et al. A systematic review and meta-analysis of Harmonic technology compared with conventional techniques in mastectomy and breast-conserving surgery with lymphadenectomy for breast cancer. Breast Cancer (Dove Med Press) 2016; 8: 125-40.
[10]	Cheng H, Soleas IM, Ferko NC, Cameron CG, Clymer JW, Amaral JF. Hospital costs associated with thyroidectomy performed with a Harmonic device compared to conventional techniques: a systematic review and meta-analysis. Journal of Medical Economics 2016; 19 (8): 750-8.
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[12]	Casadei R, Ricci C, Pacilio CA, Ingaldi C, Taffurelli G, Minni F. Laparoscopic distal pancreatectomy: which factors are related to open conversion? Lessons learned from 68 consecutive procedures in a high-volume pancreatic center. Surg Endosc 2018; 32: 3839-45.
[13]	Kim KJ, Chung JH, Lee HC, Lee BI, Park SH, Yoon ES. Comparison of Harmonic scalpel and monopolar cautery for capsulectomy at the second stage of expander/implant breast reconstruction. Arch Plast Surg 2020; 47: 140-5.
[14]	McCarus SD. McCarus Minimally Invasive Hysterectomy: 20 Years' Experience-Lessons Learned. Surgical technology international 2018; 33: 207-14.
[15]	Otsuka K, Murakami M, Goto S, et al. Minimally invasive esophagectomy and radical lymph node dissection without recurrent laryngeal nerve paralysis. Surg Endosc 2020; 34: 2749-57.

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APA Style

David Singleton, Natalia Juncosa-Melvin, Patrick Scoggins, Geisa Paulin-Curlee, John Cummings, et al. (2020). Intelligent Ultrasonic Energy: New Adaptive Tissue Technology in Harmonic Shears. Journal of Surgery, 8(6), 178-183. https://doi.org/10.11648/j.js.20200806.12

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ACS Style

David Singleton; Natalia Juncosa-Melvin; Patrick Scoggins; Geisa Paulin-Curlee; John Cummings, et al. Intelligent Ultrasonic Energy: New Adaptive Tissue Technology in Harmonic Shears. J. Surg. 2020, 8(6), 178-183. doi: 10.11648/j.js.20200806.12

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AMA Style

David Singleton, Natalia Juncosa-Melvin, Patrick Scoggins, Geisa Paulin-Curlee, John Cummings, et al. Intelligent Ultrasonic Energy: New Adaptive Tissue Technology in Harmonic Shears. J Surg. 2020;8(6):178-183. doi: 10.11648/j.js.20200806.12

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@article{10.11648/j.js.20200806.12,
  author = {David Singleton and Natalia Juncosa-Melvin and Patrick Scoggins and Geisa Paulin-Curlee and John Cummings and Crystal Ricketts},
  title = {Intelligent Ultrasonic Energy: New Adaptive Tissue Technology in Harmonic Shears},
  journal = {Journal of Surgery},
  volume = {8},
  number = {6},
  pages = {178-183},
  doi = {10.11648/j.js.20200806.12},
  url = {https://doi.org/10.11648/j.js.20200806.12},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.js.20200806.12},
  abstract = {Objective: Development of ultrasonic technology in surgical devices includes mechanisms of monitoring and adjusting energy delivery to target tissues for the purpose of limiting thermal spread. The objective of the current study was to evaluate performance of a new Adaptive Tissue Technology algorithm, designed to enhance thermal management in the HARMONIC 1100 Shears. Methods: The HARMONIC 1100 Shears were evaluated with bench-top and in vivo preclinical (porcine) analyses for tissue thermal spread, blade heat, transection speed, hemostasis and vessel sealing performance. Testing was performed in parallel with the current production HARMONIC HD 1000i Shears to confirm non-inferiority of the new Adaptive Tissue Technology algorithm. Results: Bench top analysis revealed significantly lower average maximum blade temperatures for HARMONIC 1100 compared to HARMONIC HD 1000i as well as HARMONIC ACE+ 7 Shears with Advanced Hemostasis. Thermal spread, transection speeds, and burst pressure tests of excised porcine carotid arteries did not show a statistical difference between HARMONIC 1100 and HD 1000iShears. In vivo analysis of hemostasis following sealing/transection of various blood vessels in acute porcine testing demonstrated similar efficacy for HARMONIC 1100 and HD 1000i Shears. Likewise, tissue lateral thermal damage showed no statistical difference between the new and previous generation Harmonic device in the porcine model. Conclusion: The new Adaptive Tissue Technology in HARMONIC 1100 Shears allows for reduced maximum blade temperatures while providing effective hemostasis, sealing strength, transection speed, and limited thermal damage.},
 year = {2020}
}

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TY  - JOUR
T1  - Intelligent Ultrasonic Energy: New Adaptive Tissue Technology in Harmonic Shears
AU  - David Singleton
AU  - Natalia Juncosa-Melvin
AU  - Patrick Scoggins
AU  - Geisa Paulin-Curlee
AU  - John Cummings
AU  - Crystal Ricketts
Y1  - 2020/11/04
PY  - 2020
N1  - https://doi.org/10.11648/j.js.20200806.12
DO  - 10.11648/j.js.20200806.12
T2  - Journal of Surgery
JF  - Journal of Surgery
JO  - Journal of Surgery
SP  - 178
EP  - 183
PB  - Science Publishing Group
SN  - 2330-0930
UR  - https://doi.org/10.11648/j.js.20200806.12
AB  - Objective: Development of ultrasonic technology in surgical devices includes mechanisms of monitoring and adjusting energy delivery to target tissues for the purpose of limiting thermal spread. The objective of the current study was to evaluate performance of a new Adaptive Tissue Technology algorithm, designed to enhance thermal management in the HARMONIC 1100 Shears. Methods: The HARMONIC 1100 Shears were evaluated with bench-top and in vivo preclinical (porcine) analyses for tissue thermal spread, blade heat, transection speed, hemostasis and vessel sealing performance. Testing was performed in parallel with the current production HARMONIC HD 1000i Shears to confirm non-inferiority of the new Adaptive Tissue Technology algorithm. Results: Bench top analysis revealed significantly lower average maximum blade temperatures for HARMONIC 1100 compared to HARMONIC HD 1000i as well as HARMONIC ACE+ 7 Shears with Advanced Hemostasis. Thermal spread, transection speeds, and burst pressure tests of excised porcine carotid arteries did not show a statistical difference between HARMONIC 1100 and HD 1000iShears. In vivo analysis of hemostasis following sealing/transection of various blood vessels in acute porcine testing demonstrated similar efficacy for HARMONIC 1100 and HD 1000i Shears. Likewise, tissue lateral thermal damage showed no statistical difference between the new and previous generation Harmonic device in the porcine model. Conclusion: The new Adaptive Tissue Technology in HARMONIC 1100 Shears allows for reduced maximum blade temperatures while providing effective hemostasis, sealing strength, transection speed, and limited thermal damage.
VL  - 8
IS  - 6
ER  -

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Author Information

David Singleton

Department of Medical Affairs, Ethicon, Inc., Blue Ash, Ohio, USA
Natalia Juncosa-Melvin

Department of Preclinical Research, Ethicon, Inc., Blue Ash, Ohio, USA
Patrick Scoggins

Department of Research and Development, Ethicon, Inc., Blue Ash, Ohio, USA
Geisa Paulin-Curlee

Department of Preclinical Research, Ethicon, Inc., Blue Ash, Ohio, USA
John Cummings

Department of Preclinical Research, Ethicon, Inc., Blue Ash, Ohio, USA
Crystal Ricketts

Department of Medical Affairs, Ethicon, Inc., Blue Ash, Ohio, USA

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Plain Text BibTeX RIS

APA Style

David Singleton, Natalia Juncosa-Melvin, Patrick Scoggins, Geisa Paulin-Curlee, John Cummings, et al. (2020). Intelligent Ultrasonic Energy: New Adaptive Tissue Technology in Harmonic Shears. Journal of Surgery, 8(6), 178-183. https://doi.org/10.11648/j.js.20200806.12

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ACS Style

David Singleton; Natalia Juncosa-Melvin; Patrick Scoggins; Geisa Paulin-Curlee; John Cummings, et al. Intelligent Ultrasonic Energy: New Adaptive Tissue Technology in Harmonic Shears. J. Surg. 2020, 8(6), 178-183. doi: 10.11648/j.js.20200806.12

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AMA Style

David Singleton, Natalia Juncosa-Melvin, Patrick Scoggins, Geisa Paulin-Curlee, John Cummings, et al. Intelligent Ultrasonic Energy: New Adaptive Tissue Technology in Harmonic Shears. J Surg. 2020;8(6):178-183. doi: 10.11648/j.js.20200806.12

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@article{10.11648/j.js.20200806.12,
  author = {David Singleton and Natalia Juncosa-Melvin and Patrick Scoggins and Geisa Paulin-Curlee and John Cummings and Crystal Ricketts},
  title = {Intelligent Ultrasonic Energy: New Adaptive Tissue Technology in Harmonic Shears},
  journal = {Journal of Surgery},
  volume = {8},
  number = {6},
  pages = {178-183},
  doi = {10.11648/j.js.20200806.12},
  url = {https://doi.org/10.11648/j.js.20200806.12},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.js.20200806.12},
  abstract = {Objective: Development of ultrasonic technology in surgical devices includes mechanisms of monitoring and adjusting energy delivery to target tissues for the purpose of limiting thermal spread. The objective of the current study was to evaluate performance of a new Adaptive Tissue Technology algorithm, designed to enhance thermal management in the HARMONIC 1100 Shears. Methods: The HARMONIC 1100 Shears were evaluated with bench-top and in vivo preclinical (porcine) analyses for tissue thermal spread, blade heat, transection speed, hemostasis and vessel sealing performance. Testing was performed in parallel with the current production HARMONIC HD 1000i Shears to confirm non-inferiority of the new Adaptive Tissue Technology algorithm. Results: Bench top analysis revealed significantly lower average maximum blade temperatures for HARMONIC 1100 compared to HARMONIC HD 1000i as well as HARMONIC ACE+ 7 Shears with Advanced Hemostasis. Thermal spread, transection speeds, and burst pressure tests of excised porcine carotid arteries did not show a statistical difference between HARMONIC 1100 and HD 1000iShears. In vivo analysis of hemostasis following sealing/transection of various blood vessels in acute porcine testing demonstrated similar efficacy for HARMONIC 1100 and HD 1000i Shears. Likewise, tissue lateral thermal damage showed no statistical difference between the new and previous generation Harmonic device in the porcine model. Conclusion: The new Adaptive Tissue Technology in HARMONIC 1100 Shears allows for reduced maximum blade temperatures while providing effective hemostasis, sealing strength, transection speed, and limited thermal damage.},
 year = {2020}
}

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TY  - JOUR
T1  - Intelligent Ultrasonic Energy: New Adaptive Tissue Technology in Harmonic Shears
AU  - David Singleton
AU  - Natalia Juncosa-Melvin
AU  - Patrick Scoggins
AU  - Geisa Paulin-Curlee
AU  - John Cummings
AU  - Crystal Ricketts
Y1  - 2020/11/04
PY  - 2020
N1  - https://doi.org/10.11648/j.js.20200806.12
DO  - 10.11648/j.js.20200806.12
T2  - Journal of Surgery
JF  - Journal of Surgery
JO  - Journal of Surgery
SP  - 178
EP  - 183
PB  - Science Publishing Group
SN  - 2330-0930
UR  - https://doi.org/10.11648/j.js.20200806.12
AB  - Objective: Development of ultrasonic technology in surgical devices includes mechanisms of monitoring and adjusting energy delivery to target tissues for the purpose of limiting thermal spread. The objective of the current study was to evaluate performance of a new Adaptive Tissue Technology algorithm, designed to enhance thermal management in the HARMONIC 1100 Shears. Methods: The HARMONIC 1100 Shears were evaluated with bench-top and in vivo preclinical (porcine) analyses for tissue thermal spread, blade heat, transection speed, hemostasis and vessel sealing performance. Testing was performed in parallel with the current production HARMONIC HD 1000i Shears to confirm non-inferiority of the new Adaptive Tissue Technology algorithm. Results: Bench top analysis revealed significantly lower average maximum blade temperatures for HARMONIC 1100 compared to HARMONIC HD 1000i as well as HARMONIC ACE+ 7 Shears with Advanced Hemostasis. Thermal spread, transection speeds, and burst pressure tests of excised porcine carotid arteries did not show a statistical difference between HARMONIC 1100 and HD 1000iShears. In vivo analysis of hemostasis following sealing/transection of various blood vessels in acute porcine testing demonstrated similar efficacy for HARMONIC 1100 and HD 1000i Shears. Likewise, tissue lateral thermal damage showed no statistical difference between the new and previous generation Harmonic device in the porcine model. Conclusion: The new Adaptive Tissue Technology in HARMONIC 1100 Shears allows for reduced maximum blade temperatures while providing effective hemostasis, sealing strength, transection speed, and limited thermal damage.
VL  - 8
IS  - 6
ER  -

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