Use of the ENSEAL® G2 tissue sealer in gynecologic surgery.

Minimally invasive surgery (MIS) has become the standard of care for a variety of surgical conditions, and reliable vessel sealing and precise cutting are essential. A variety of tissue-sealing devices have been used successfully to decrease operating time and control bleeding during hysterectomy and other MIS gynecologic procedures. One development involves the next generation of advanced bipolar devices by ETHICON (Ethicon Endo-Surgery Inc., Cincinnati, OH), called ENSEAL® G2 Tissue Sealers. Tip improvements to the ENSEAL® have included stronger jaws and a welded positive electrode in the stationary jaw, thus enabling the new ENSEAL® G2 Tissue Sealer to provide reliable vessel sealing and precise cutting all in the same instrument. The patented I-BLADE® forces the jaws of the device together as it advances, resulting in high, uniform compression along the entire length of the jaws. The temperature-regulating Positive Temperature Coefficient (PTC) material in the jaws is designed to minimize sticking, and the offset electrode configuration is designed to minimize thermal spread. The ergonomics provided by the ENSEAL® G2 Tissue Sealer offer significant improvement over previous devices and may make this a much more cost-effective choice for benign gynecologic procedures.

Laparoscopic Management of Ovarian Cysts with Controlled Tissue Sealing - The "Cross Bag" Technique.

When ovarian preservation is desired, a minimally invasive laparoscopic surgical procedure using a "cross bag" technique is effective to consistently manage and remove ovarian cysts of concern. In addition to the standard preoperative preparation of patients, a bowel prep is critical, especially if the mass is large or the patient obese. Visualization of all internal structures is achieved using a multi-screen HD system and 5-mm laparoscope. Over 100 cases have been performed using the "cross bag" technique with no spillage of cysts.