Evidence map›Paper›PMID 33523265›Full record

ArticleSurgical endoscopy2021

Repeated partial tissue bite with inadequate cooling time for an energy device may cause thermal injury.

Kazunori Shibao, Fumi Joden, Yasuhiro Adachi, Shiro Kohi, Yuzan Kudou, Yuta Kikuchi, Nobutaka Matayoshi, Nagahiro Sato, Ryota Murayama, Keiji Hirata

Abstract read

PubMed Publisher

In one paragraph

Article in Surgical endoscopy, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it

0cells of the map it votes in

8citing papers in PubMed, 1 pooled it

1.9field-weighted citation impact, top 15% of its field

1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 1 synthesis or guideline pooled it, 13 citations in OpenAlex.

Comparison of efficacy and costs between robotic-assisted and conventional thoracoscopic approaches for partial pulmonary resection: a systematic review and meta-analysis of propensity score-matched studies.PeerJ · 2025
Pooled it
Target trial emulation and causal machine learning define individualized safety margins for energy exposure near the recurrent laryngeal nerve in thyroidectomy: multicentre cohort study.BJS open · 2026
Article
Electrothermal bipolar vessel sealing devices are associated with lower rates of postoperative complications compared to ultrasonic devices in vulvar cancer surgery.PloS one · 2025
Article
Evaluation of thermal effects of surgical energy devices: ex vivo study.Scientific reports · 2024
Article
Features and applications of energy devices for prone robot-assisted minimally invasive esophagectomy: a narrative review.Journal of thoracic disease · 2022
Review
Tissue pad degradation of ultrasonic device may enhance thermal injury and impair its sealing performance in liver surgery.World journal of hepatology · 2022
Article
Dissection Around the Superior Mesenteric Artery (SMA) Using LigaSure Maryland During Left Posterior Approach for Pancreaticoduodenectomy.Cureus · 2022
Article
Detection of the Lateral Thermal Spread during Bipolar Vessel Sealing in an Ex Vivo Model-Preliminary Results.Diagnostics (Basel, Switzerland) · 2022
Article

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 1 institution in 1 country.

Kazunori ShibaoDepartment of Surgery I, School of Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, 807-8555, Japan. shibao@med.uoeh-u.ac.jp.

Fumi JodenDepartment of Surgery I, School of Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, 807-8555, Japan.

Yasuhiro AdachiDepartment of Surgery I, School of Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, 807-8555, Japan.

Shiro KohiDepartment of Surgery I, School of Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, 807-8555, Japan.

Yuzan KudouDepartment of Surgery I, School of Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, 807-8555, Japan.

Yuta KikuchiDepartment of Surgery I, School of Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, 807-8555, Japan.

Nobutaka MatayoshiDepartment of Surgery I, School of Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, 807-8555, Japan.

Nagahiro SatoDepartment of Surgery I, School of Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, 807-8555, Japan.

Ryota MurayamaDepartment of Surgery I, School of Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, 807-8555, Japan.

Keiji HirataDepartment of Surgery I, School of Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, 807-8555, Japan.

University of Occupational and Environmental Health Japan · JP

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundOver the past three decades, the use of ultrasonically activated device (USAD) and advanced bipolar device (ABD) has grown in minimally invasive surgeries. However, the thermal profile differences during repeated dissection with different grasping ranges of energy devices, which provide valuable information for preventing thermal injury by energy devices, remain unclear.

methodsWe developed an ex vivo benchtop model to examine the temperature profile of the blade and jaws of two USADs (HARMONIC® ACE + and Sonicision™) and a ABD (Ligasure™ Maryland) with different grasping ranges (partial tissue and full tissue bite) in repeated dissection with minimum cooling time. The maximum temperature, time required for completion to dissection of 10 cm of porcine muscle, thermal spread, and cooling time to reach 60 °C were continuously measured using video thermography. In addition, to evaluate one more grasping range "no tissue", we performed a stress test that activated the USAD without tissue intervention to assess the effects of excessive load on the blade and jaw.

resultsRepeated dissection of energy devices with minimal cooling time results in high blade and jaw temperatures proportional to the incision distance. In particular, the USADs with partial tissue bite showed a significantly higher temperatures at the blade and jaw, longer cooling times, and higher lateral thermal spread than those with a full tissue bite and the ABD. The stress test with a USAD showed an extremely high blade temperature exceeding 400 °C, with the tissue pad melting only 13.2 s after activation.

conclusionAlthough USAD with partial tissue bite help ensure precise dissection, repeated long activation with inadequate cooling time may increase the risk of thermal injury during surgery. These results suggest that surgeons should use energy devices properly while understanding the risks of adjacent organ damage that could result from abuse of the device.

Indexed as

DissectionSurgical InstrumentsAnimalsHot TemperatureMinimally Invasive Surgical ProceduresSwineTemperatureEnergy deviceLaparoscopic cutting scissorsLaparoscopic surgeryStress testThermal damageVessel-sealing system

Identifiers

PMID33523265

DOI10.1007/s00464-021-08322-3

OpenAlexW3126666360

What OpenQuestion holds

Textmetadata

Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.