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Safety and Performance of the HD1000i Shears in Urologic Procedures: A Retrospective Review

Received: 7 September 2022    Accepted: 21 September 2022    Published: 11 October 2022
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Abstract

Background: Ultrasonic devices including the Harmonic HD1000i Shears are utilized for incision, dissection, and separation and division of tissues to achieve hemostatic transection of vessels in a wide range of procedures. This study was conducted to further evaluate the safety and performance of the HD1000i in a clinical setting use during urologic procedures. Methods: The primary endpoint of this retrospective, observational, single-arm study was intra- and post-operative transfusions deemed related to study device. Secondary endpoints were occurrences of intra-operative and post-operative adverse events (AEs) or complications possibly related to the procedure or device. Adult patients who underwent open cystectomy (OC), or laparoscopic (LN) or open nephrectomy (ON) from May 1, 2018 to November 30, 2020 at Severance Hospital (South Korea) where the device had been utilized (without the use of alternative advanced energy device used) were included in this study. Results: One-hundred and five subjects met inclusion criteria: 48 in OC, 18 in ON, and 39 in LN. Overall blood transfusion rates were 52.1% (25/48), 38.9% (7/18), and 5.1% (2/39) for the OC, ON, an LN groups, respectively, and 32.4% (34/105) overall. AE’s/complications were reported in 2.9% of subjects: one in the ON group (6%) and 2 in the LN subset (5%). Conclusion: Analysis of a single institution’s experience with the Harmonic HD1000i device in urologic surgery demonstrates acceptable safety and efficacy comparable to the published literature.

Published in Journal of Surgery (Volume 10, Issue 5)
DOI 10.11648/j.js.20221005.15
Page(s) 168-174
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), 2024. Published by Science Publishing Group

Keywords

Urologic Surgery, HD1000i Shears, Safety, Performance, Ultrasonic Shears

References
[1] Otani, Y.; Ohgami, M.; Kitajima, M., Haemostatic dissection devices: Today's clinical experience and future options. Minimally Invasive Therapy & Allied Technologies 1999, 8 (2), 69-72.
[2] Gözen, A. S.; Teber, D.; Rassweiler, J. J., Principles and initial experience of a new device for dissection and hemostasis. Minimally Invasive Therapy & Allied Technologies 2007, 16 (1), 58-65.
[3] Harold, K. L.; Pollinger, H.; Matthews, B. D.; Kercher, K. W.; Sing, R. F.; Heniford, B. T., Comparison of ultrasonic energy, bipolar thermal energy, and vascular clips for the hemostasis of small-, medium-, and large-sized arteries. Surgical Endoscopy And Other Interventional Techniques 2003, 17 (8), 1228-1230.
[4] Harrell, A. G.; Kercher, K. W.; Heniford, B. T., Energy Sources in Laparoscopy. Seminars in Laparoscopic Surgery 2004, 11 (3), 201-209.
[5] Wakabayashi, T.; Abe, Y.; Kanazawa, A.; Oshima, G.; Kodai, S.; Ehara, K.; Kinugasa, Y.; Kinoshita, T.; Nomura, A.; Kawakubo, H.; Kitagawa, Y., Feasibility Study of a Newly Developed Hybrid Energy Device Used During Laparoscopic Liver Resection in a Porcine Model. Surgical Innovation 2018, 26 (3), 350-358.
[6] Phillips, C. K.; Hruby, G. W.; Durak, E.; Lehman, D. S.; Humphrey, P. A.; Mansukhani, M. M.; Landman, J., Tissue Response to Surgical Energy Devices. Urology 2008, 71 (4), 744-748.
[7] Newcomb, W. L.; Hope, W. W.; Schmelzer, T. M.; Heath, J. J.; Norton, H. J.; Lincourt, A. E.; Heniford, B. T.; Iannitti, D. A., Comparison of blood vessel sealing among new electrosurgical and ultrasonic devices. Surgical Endoscopy 2009, 23 (1), 90-96.
[8] Bittner, J. G.; Varela, J. E.; Herron, D., Ultrasonic Energy Systems. In The SAGES Manual on the Fundamental Use of Surgical Energy (FUSE), Feldman, L.; Fuchshuber, P.; Jones, D. B., Eds. Springer New York: New York, NY, 2012; pp 123-132.
[9] Schmidbauer, S.; Hallfeldt, K. K.; Sitzmann, G.; Kantelhardt, T.; Trupka, A., Experience with ultrasound scissors and blades (UltraCision) in open and laparoscopic liver resection. Ann Surg 2002, 235 (1), 27-30.
[10] Broughton, D.; Welling, A. L.; Monroe, E. H.; Pirozzi, K.; Schulte, J. B.; Clymer, J. W., Tissue effects in vessel sealing and transection from an ultrasonic device with more intelligent control of energy delivery. Med Devices (Auckl) 2013, 6, 151-4.
[11] Targarona, E. M.; Balague, C.; Marin, J.; Neto, R. B.; Martinez, C.; Garriga, J.; Trias, M., Energy Sources for Laparoscopic Colectomy: A Prospective Randomized Comparison of Conventional Electrosurgery, Bipolar Computer-Controlled Electrosurgery and Ultrasonic Dissection. Operative Outcome and Costs Analysis. Surgical Innovation 2005, 12 (4), 339-344.
[12] McCarus, S. D., McCarus Minimally Invasive Hysterectomy: 20 Years' Experience-Lessons Learned. Surgical technology international 2018, 33, 207-214.
[13] Kondrup, J. D.; Anderson, F.; Sylvester, B.; Branning, M., The New HARMONIC ACE®+7 Shears: A Game Changer in Ultrasonic Hemostasis. Surgical technology international 2014, 25, 24-27.
[14] Timm, R. W.; Asher, R. M.; Tellio, K. R.; Welling, A. L.; Clymer, J. W.; Amaral, J. F., Sealing vessels up to 7 mm in diameter solely with ultrasonic technology. Med Devices (Auckl) 2014, 7, 263-271.
[15] Landman, J.; Kerbl, K.; Rehman, J.; Andreoni, C.; Humphrey, P. A.; Collyer, W.; Olweny, E.; Sundaram, C.; Clayman, R. V., Evaluation of a vessel sealing system, bipolar electrosurgery, harmonic scalpel, titanium clips, endoscopic gastrointestinal anastomosis vascular staples and sutures for arterial and venous ligation in a porcine model. J Urol 2003, 169 (2), 697-700.
[16] Welling, A. L.; Scoggins, P. J.; Cummings, J. F.; Clymer, J. W.; Amaral, J. F. In Superior Dissecting Capability of A New Ultrasonic Device Improves Efficiency and Reduces Adhesion Formation, 2017.
[17] Otsuka, K.; Murakami, M.; Goto, S.; Ariyoshi, T.; Yamashita, T.; Saito, A.; Kohmoto, M.; Kato, R.; Lefor, A. K.; Aoki, T., Minimally invasive esophagectomy and radical lymph node dissection without recurrent laryngeal nerve paralysis. Surgical Endoscopy 2020, 34 (6), 2749-2757.
[18] Kim, K. J.; Chung, J. H.; Lee, H. C.; Lee, B. I.; Park, S. H.; Yoon, E. S., Comparison of Harmonic scalpel and monopolar cautery for capsulectomy at the second stage of expander/implant breast reconstruction. Archives of plastic surgery 2020, 47 (2), 140-145.
[19] Yokoyama, Y.; Tajima, Y.; Matsuda, I.; Kamada, K.; Ikehara, T.; Uekusa, T.; Momose, H.; Yoneyama, S.; Sakata, H.; Hidemura, A.; Suzuki, H.; Ishimaru, M., Differential diagnosis and laparoscopic resection of an adrenal pseudocyst: A case report. International Journal of Surgery Case Reports 2020, 72, 178-182.
[20] Casadei, R.; Ricci, C.; Pacilio, C. A.; 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. Surgical Endoscopy 2018, 32 (9), 3839-3845.
[21] Ota, H.; Ishida, H.; Matsumoto, H.; Ishiyama, T., An extremely rare case of desmoplastic fibroblastoma exhibiting rapid growth in the chest wall: a case report. Surgical Case Reports 2021, 7 (1), 86.
[22] Alluri, R. K.; Leland, H.; Heckmann, N., Surgical research using national databases. Annals of translational medicine 2016, 4 (20).
[23] Lowrance, W. T.; Rumohr, J. A.; Chang, S. S.; Clark, P. E.; Smith, J. A.; Cookson, M. S., Contemporary open radical cystectomy: analysis of perioperative outcomes. The Journal of urology 2008, 179 (4), 1313-1318.
[24] Furrer, M. A.; Abgottspon, J.; Huber, M.; Engel, D.; Löffel, L. M.; Beilstein, C. M.; Burkhard, F. C.; Wuethrich, P. Y., Perioperative continuation of aspirin, oral anticoagulants or bridging with therapeutic low-molecular-weight heparin does not increase intraoperative blood loss and blood transfusion rate in cystectomy patients: an observational cohort study. BJU International 2022, 129 (4), 512-523.
[25] Zaid, H. B.; Yang, D. Y.; Tollefson, M. K.; Frank, I.; Winters, J. L.; Thapa, P.; Parker, W. P.; Thompson, R. H.; Karnes, R. J.; Boorjian, S. A., Efficacy and safety of intraoperative tranexamic acid infusion for reducing blood transfusion during open radical cystectomy. Urology 2016, 92, 57-62.
[26] Kluth, L. A.; Xylinas, E.; Rieken, M.; El Ghouayel, M.; Sun, M.; Karakiewicz, P. I.; Lotan, Y.; Chun, F. K. H.; Boorjian, S. A.; Lee, R. K.; Briganti, A.; Rouprêt, M.; Fisch, M.; Scherr, D. S.; Shariat, S. F., Impact of peri-operative blood transfusion on the outcomes of patients undergoing radical cystectomy for urothelial carcinoma of the bladder. BJU International 2014, 113 (3), 393-398.
[27] Wuethrich, P. Y.; Studer, U. E.; Thalmann, G. N.; Burkhard, F. C., Intraoperative continuous norepinephrine infusion combined with restrictive deferred hydration significantly reduces the need for blood transfusion in patients undergoing open radical cystectomy: results of a prospective randomised trial. European urology 2014, 66 (2), 352-360.
[28] Luciani, L. G.; Chiodini, S.; Mattevi, D.; Cai, T.; Puglisi, M.; Mantovani, W.; Malossini, G., Robotic-assisted partial nephrectomy provides better operative outcomes as compared to the laparoscopic and open approaches: results from a prospective cohort study. Journal of robotic surgery 2017, 11 (3), 333-339.
[29] Vricella, G. J.; Finelli, A.; Alibhai, S. M. H.; Ponsky, L. E.; Abouassaly, R., The true risk of blood transfusion after nephrectomy for renal masses: a population-based study. BJU International 2013, 111 (8), 1294-1300.
[30] Bayrak, O.; Seckiner, I.; Erturhan, S.; Cil, G.; Erbagci, A.; Yagci, F., Comparison of the complications and the cost of open and laparoscopic radical nephrectomy in renal tumors larger than 7 centimeters. Urology Journal 2014, 11 (1), 1222-1227.
[31] Bragayrac, L. A. N.; Abbotoy, D.; Attwood, K.; Darwiche, F.; Hoffmeyer, J.; Kauffman, E. C.; Schwaab, T., Outcomes of minimal invasive vs open radical nephrectomy for the treatment of locally advanced renal-cell carcinoma. Journal of Endourology 2016, 30 (8), 871-876.
[32] HIGASHIHARA, E.; BABA, S.; NAKAGAWA, K.; MURAI, M.; GO, H.; TAKEDA, M.; TAKAHASHI, K.; SUZUKI, K.; FUJITA, K.; ONO, Y., Learning curve and conversion to open surgery in cases of laparoscopic adrenalectomy and nephrectomy. The Journal of urology 1998, 159 (3), 650-653.
[33] Reifsnyder, J. E.; Ramasamy, R.; Ng, C. K.; Dipietro, J.; Shin, B.; Shariat, S. F.; Del Pizzo, J. J.; Scherr, D. S., Laparoscopic and open partial nephrectomy: complication comparison using the Clavien system. Jsls 2012, 16 (1), 38-44.
[34] Wessels, F.; Kriegmair, M. C.; Oehme, A.; Rassweiler-Seyfried, M. C.; Erben, P.; Oberneder, R.; Kriegmair, M.; Ritter, M.; Michel, M. S.; Honeck, P., Radical cystectomy under continuous antiplatelet therapy with acetylsalicylic acid. European Journal of Surgical Oncology 2019, 45 (7), 1260-1265.
[35] Shuford, M. D.; McDougall, E. M.; Chang, S. S.; LaFleur, B. J.; Smith, J. A.; Cookson, M. S., Complications of contemporary radical nephrectomy: comparison of open vs. laparoscopic approach. Urologic Oncology: Seminars and Original Investigations 2004, 22 (2), 121-126.
Cite This Article
  • APA Style

    Mordechai Goode Sadowsky, Won Sik Jang, Subin Lim, DongKyu Kim, Jason Robert Waggoner, et al. (2022). Safety and Performance of the HD1000i Shears in Urologic Procedures: A Retrospective Review. Journal of Surgery, 10(5), 168-174. https://doi.org/10.11648/j.js.20221005.15

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    ACS Style

    Mordechai Goode Sadowsky; Won Sik Jang; Subin Lim; DongKyu Kim; Jason Robert Waggoner, et al. Safety and Performance of the HD1000i Shears in Urologic Procedures: A Retrospective Review. J. Surg. 2022, 10(5), 168-174. doi: 10.11648/j.js.20221005.15

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    AMA Style

    Mordechai Goode Sadowsky, Won Sik Jang, Subin Lim, DongKyu Kim, Jason Robert Waggoner, et al. Safety and Performance of the HD1000i Shears in Urologic Procedures: A Retrospective Review. J Surg. 2022;10(5):168-174. doi: 10.11648/j.js.20221005.15

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  • @article{10.11648/j.js.20221005.15,
      author = {Mordechai Goode Sadowsky and Won Sik Jang and Subin Lim and DongKyu Kim and Jason Robert Waggoner and Philippe Grange and Paula Priscilla Veldhuis and Giovanni Antonio Tommaselli},
      title = {Safety and Performance of the HD1000i Shears in Urologic Procedures: A Retrospective Review},
      journal = {Journal of Surgery},
      volume = {10},
      number = {5},
      pages = {168-174},
      doi = {10.11648/j.js.20221005.15},
      url = {https://doi.org/10.11648/j.js.20221005.15},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.js.20221005.15},
      abstract = {Background: Ultrasonic devices including the Harmonic HD1000i Shears are utilized for incision, dissection, and separation and division of tissues to achieve hemostatic transection of vessels in a wide range of procedures. This study was conducted to further evaluate the safety and performance of the HD1000i in a clinical setting use during urologic procedures. Methods: The primary endpoint of this retrospective, observational, single-arm study was intra- and post-operative transfusions deemed related to study device. Secondary endpoints were occurrences of intra-operative and post-operative adverse events (AEs) or complications possibly related to the procedure or device. Adult patients who underwent open cystectomy (OC), or laparoscopic (LN) or open nephrectomy (ON) from May 1, 2018 to November 30, 2020 at Severance Hospital (South Korea) where the device had been utilized (without the use of alternative advanced energy device used) were included in this study. Results: One-hundred and five subjects met inclusion criteria: 48 in OC, 18 in ON, and 39 in LN. Overall blood transfusion rates were 52.1% (25/48), 38.9% (7/18), and 5.1% (2/39) for the OC, ON, an LN groups, respectively, and 32.4% (34/105) overall. AE’s/complications were reported in 2.9% of subjects: one in the ON group (6%) and 2 in the LN subset (5%). Conclusion: Analysis of a single institution’s experience with the Harmonic HD1000i device in urologic surgery demonstrates acceptable safety and efficacy comparable to the published literature.},
     year = {2022}
    }
    

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  • TY  - JOUR
    T1  - Safety and Performance of the HD1000i Shears in Urologic Procedures: A Retrospective Review
    AU  - Mordechai Goode Sadowsky
    AU  - Won Sik Jang
    AU  - Subin Lim
    AU  - DongKyu Kim
    AU  - Jason Robert Waggoner
    AU  - Philippe Grange
    AU  - Paula Priscilla Veldhuis
    AU  - Giovanni Antonio Tommaselli
    Y1  - 2022/10/11
    PY  - 2022
    N1  - https://doi.org/10.11648/j.js.20221005.15
    DO  - 10.11648/j.js.20221005.15
    T2  - Journal of Surgery
    JF  - Journal of Surgery
    JO  - Journal of Surgery
    SP  - 168
    EP  - 174
    PB  - Science Publishing Group
    SN  - 2330-0930
    UR  - https://doi.org/10.11648/j.js.20221005.15
    AB  - Background: Ultrasonic devices including the Harmonic HD1000i Shears are utilized for incision, dissection, and separation and division of tissues to achieve hemostatic transection of vessels in a wide range of procedures. This study was conducted to further evaluate the safety and performance of the HD1000i in a clinical setting use during urologic procedures. Methods: The primary endpoint of this retrospective, observational, single-arm study was intra- and post-operative transfusions deemed related to study device. Secondary endpoints were occurrences of intra-operative and post-operative adverse events (AEs) or complications possibly related to the procedure or device. Adult patients who underwent open cystectomy (OC), or laparoscopic (LN) or open nephrectomy (ON) from May 1, 2018 to November 30, 2020 at Severance Hospital (South Korea) where the device had been utilized (without the use of alternative advanced energy device used) were included in this study. Results: One-hundred and five subjects met inclusion criteria: 48 in OC, 18 in ON, and 39 in LN. Overall blood transfusion rates were 52.1% (25/48), 38.9% (7/18), and 5.1% (2/39) for the OC, ON, an LN groups, respectively, and 32.4% (34/105) overall. AE’s/complications were reported in 2.9% of subjects: one in the ON group (6%) and 2 in the LN subset (5%). Conclusion: Analysis of a single institution’s experience with the Harmonic HD1000i device in urologic surgery demonstrates acceptable safety and efficacy comparable to the published literature.
    VL  - 10
    IS  - 5
    ER  - 

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Author Information
  • Ethicon, Inc. Cincinnati, United States of America

  • Department of Urology and Urological Science Institute, Yonsei University College of Medicine, Seoul, Republic of Korea

  • Real-World Evidence Team, Yonsei University Health System, Seoul, Republic of Korea

  • Real-World Evidence Team, Yonsei University Health System, Seoul, Republic of Korea

  • Ethicon, Inc. Cincinnati, United States of America

  • Department of Family Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea

  • Ethicon, Inc. Cincinnati, United States of America

  • Ethicon, Inc. Cincinnati, United States of America

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