Initial Clinical Experience With the ENSEAL® G2 Articulating Tissue Sealer in Laparoscopic Colectomy

The ENSEAL® G2 Tissue Sealer is a sterile, single-patient use surgical instrument used to coagulate and transect vessels up to and including 7mm in diameter and tissue and/or vascular bundles. In preclinical research using ENSEAL tissue sealers, burst pressures were 51% higher for perpendicularly sealed vessels than for angled seals (p<0.001) and the seal length was the primary variable in determining burst pressure (Voegele AC, 2013). These results suggest that the strongest possible seal may be obtained when vessels are approached perpendicularly and not at an angle.

However, desired angles for vessel sealing cannot always be obtained in the surgical field, especially in laparoscopic surgery due mostly to the fixed nature of the abdominal wall cannulas and the lack of adequate articulating hemostatic tools.

Since strong vessel seals are important for adequate homeostasis, the value of an articulating vessel-sealing device primarily resides in its ability to maneuver around corners and behind structures in confined spaces. An articulating vessel-sealing device would maximize the ability to approach vessels or bundles in a perpendicular manner to provide greater seal strength.

ENSEAL ART is the first articulating advanced bipolar device that can facilitate laparoscopic surgery through a 5mm port. The instrument shaft, can achieve up to 110 degrees of articulation (which improves the visibility of the tip of the device's jaw) to gain access to tissue in challenging anatomy, especially in deep/tight spaces, and facilitate additional angles to transect and seal tissue, vessels, and vascular bundles.

The articulation feature and improved ergonomics of the ENSEAL ART may provide the ability to maneuver around corners and behind structures, while making it easier to capture the full vessel in a single bite. These features may lead to a reduction of the number of ports, the instrument exchanges between ports, the need to pass the energy device to an assistant, and the number of times the surgical table tilt has to be changed during certain laparoscopic surgical procedures (e.g., colectomy).