Minimizing thermal damage using self-cooling jaws for radiofrequency intestinal tissue fusion.

INTRODUCTION: Radiofrequency (RF)-induced tissue fusion shows great potential in sealing intestinal tissue without foreign materials. To improve the performance of RF-induced tissue fusion, a novel self-cooling jaw has been designed to minimize thermal damage during the fusion. MATERIAL AND METHODS: The prototype of self-cooling jaws was developed and manufactured. A total number of 60 mucosa-to-mucosa fusions were conducted using ex-vivo porcine intestinal segments with the proposed design and conventional bipolar jaws. The effects of intestinal fusion were evaluated based on temperature curves, burst pressure, thermal damage, and histological appearances. RESULTS: The self-cooling jaws showed significant decrease in temperature during the fusion process. An optimal burst pressure (5.7 ± 0.5 kPa) and thermal damage range (0.9 ± 0.1 mm) were observed when the applied RF power was 100 W. The thermal damage range of the prototype has almost decreased 36% in comparison with the conventional bipolar jaws (1.4 ± 0.1 mm). The histological observation revealed that a decrease of thermal damage was achieved through the application of self-cooling jaws. CONCLUSIONS: The self-cooling jaws were proved to be effective for reducing the thermal damage during RF-induced tissue fusion, which could potentially promote the clinical application of tissue fusion techniques in the future.

Preliminary study of a control algorithm for radio-frequency-induced intestinal tissue fusion.

Purpose: A control algorithm for radio-frequency-induced intestinal tissue fusion was developed to explore the effects of different control parameters on intestinal tissue fusion.Materials and methods: Radio-frequency-induced fusion was performed on ex vivo small intestine tissue. The effect on the fusion was observed by changing the control parameters (power, interval time, and terminal impedance) in the algorithm. The quality of fusion was evaluated using the burst pressure and thermal damage measurement. Histological evaluation was used to assess the fusion quality indirectly.Results: A maximum burst pressure of 8.460 ± 0.2674 KPa was acquired when the power was set to 100 W, the interval time was set to 2000 ms, and the terminal impedance was set to 50 Ω. Moreover, the thermal damage range increased with an increase in power but decreased with an increase in the interval time and terminal impedance. Furthermore, the thermal damage range and temperature were presumably related.Conclusions: For an ex vivo small intestine tissue, the appropriate control parameters could be set when the power was approximately 100 W, the interval time was approximately 2000 ms, and the terminal impedance was approximately 50 Ω. This study could provide a basis for the selection of control parameters for intestinal tissue fusion.