Analysis of Pancreatic Tissue Injury Caused by Ultrasonically Activated Devices

Pancreatic fistula has been reported to occur more frequently in laparoscopic surgery than conventional open surgery. An ultrasonically activated device (USAD) has been raised as one of the cause of that, because of its frequent usage in laparoscopic surgeries and allegedly harmful side effect such as cavitation and/or lateral thermal effect. This research has been conducted to determine whether USAD could be the direct cause of pancreatic fistula using an animal model. The pancreas of a 3-month-old domestic pig weighing 30 kg was exposed under general anesthesia. USADs were activated in contact with the pancreas with various activation times and locations of the blades, and histopathological analyses of the specimens were performed. As a result, coagulation necrosis was observed at activation sites in all specimens. However, much less protein clotting covering the damaged sites was observed with USADs compared with electric scalpels. These data suggest that USADs are more likely to cause pancreatic tissue damage which leads to pancreatic fistula compared with conventional electric scalpels.