Abstract:

Bipolar radiofrequency (RF) energy can successfully seal vascular structures up to 7 mm by fusing collagen and elastin in the lumen. Valleylab has created a system to expand this technology beyond vessel sealing with the development of a closed-loop, feedback-control RF generator that closely monitors tissue fusion. This generator, operating with a loop time of approximately 250 μs, continuously adjusts energy output, creating optimized soft-tissue fusion through structural protein amalgamation. In the first study, RF energy was applied to canine lung using the new-generation generator and lung-prototype device. A lobectomy was completed, sealing the lobar bronchus, parenchyma, and pulmonary vasculature. Chronic performance of the seals was evaluated at necropsy on postoperative days 7 and 14. In a second study, RF energy was applied to porcine small intestine using the same closed-loop generator and anastomosis prototype device. Acute tissue fusion was assessed qualitatively for hemostasis and seal quality. Terminal tissue evaluation was completed on postoperative day 7 and analyzed histopathologically. Histopathology confirmed acute and chronic tissue fusion in both the lung and intestine. Normal pathological healing was substantiated by angiogenesis, granulation, and proliferation of fibroblasts. Preliminary studies using canine lung and porcine small intestine demonstrate the potential of this closed-loop generator for soft-tissue amalgamation. Advanced monitoring capabilities make this fusion system applicable in many soft-tissue structures with adequate collagen and elastin. Further investigation of potential surgical applications needs to be completed.

Authors:

Chelsea A Shields, B.S., David A Schechter, B.S., Phillip Tetzlaff, B.S., Ali L Baily, B.S., Sean Dycus, B.S., Ned Cosgriff, M.D.

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