Ann Surg Treat Res.  2023 Aug;105(2):91-98. 10.4174/astr.2023.105.2.91.

Comparison of Medisonic with Harmonic HD 1000i and Sonicision ultrasonic energy device in laparoscopic gastrectomy: a pilot randomized clinical trial

• Kim SJ
• Gadah A
• Song KY

• KMID: 2545160
• DOI: http://doi.org/10.4174/astr.2023.105.2.91

Abstract

Purpose
This study aimed to compare the clinical performance of Medisonic (Daiwha Corp.) to that of Harmonic HD 1000i (Ethicon Endo-Surgery Inc.) and Sonicision (Medtronic) in patients undergoing gastrectomy for gastric cancer.
Methods
A total of 30 patients were enrolled in this prospective randomized study. The patients were randomly assigned to a Medisonic (M group, n = 10), Harmonic HD 1000i (H group, n = 10), or Sonicision (S group, n = 10) groups. Primary outcome was cutting speed and activation times during omentectomy. Other variables were visibility of surgical field, blade stickiness, and clinical outcomes, including operation-related complications.
Results
Clinicopathologic characteristics, including age, sex, body mass index, or stage were not different between the 3 groups. Operative outcomes, including operation time, estimated blood loss, and postoperative hospital stay were not different between the 3 groups. There was no significant difference in 30-day postoperative complications. The running time of omentectomy was 7.3, 9.2, and 8.7 minutes in the H, S, and M groups, respectively, with no statistical difference (P = 0.589). We also looked at the activation times during the omentectomy, and there was no statistical difference between the groups (52.6 times vs. 58.9 times vs. 56.2 times in the H, S, and M groups, respectively; P = 0.860).
Conclusion
Medisonic is safe and efficient to perform laparoscopic radical gastrectomy and is not inferior to Harmonic HD 1000i or Sonicision in terms of clinical outcomes and cutting/sealing function.

Keyword

Stomach neoplasms; Laparoscopy; Ultrasonic device

Figure

• 

  Fig. 1 Medisonic DU-3 device (Daiwha Corp.) has a built-in transducer that allows the wheel to rotate 360° continuously without twisting the cable.

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  Fig. 2 Representative photos by the degree of visibility. Visibility was defined as the degree to which the surgical fields were obscured by the fog/smoke caused by using ultrasonic coagulating shears during the omentectomy. (A) Moderate, fog spreading all over the screen for <10 seconds; (B) severe, fog was maintained over 10 seconds.

• 

  Fig. 3 Representative photos by the degree of stickiness. The blade stickiness was defined as the degree of tissue attached to the blade of the instrument and was classified as mild, moderate, and severe. (A) Mild, <50% of the blade; (B) moderate, between 50% and 70% of the blade; and (C) severe, >70% of the blade.

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  Fig. 4 Main outcomes. (A) Duration of omentectomy. (B) Activation times during the omentectomy. (C) Cutting speed for dividing the 4 major gastric arteries. (D) Visibility of the operation fields. (E) Blade stickiness after 30 minutes of operation. (F) Times of lens cleansing during the omentectomy. Harmonic, Ethicon Endo-Surgery Inc.; Sonicision, Medtronic; Medisonic, Daiwha Corp. The number of patients for each device is 10. LGEA, left gastroepiploic artery; RGEA, right gastroepiploic artery; RGA, right gastric artery; LGA, left gastric artery.

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