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Botteri E, Podda M, Arezzo A, Vettoretto N, Sartori A, Agrusa A, Allaix ME, Anania G, Brachet Contul R, Caracino V, Cassinotti E, Cuccurullo D, D'Ambrosio G, Milone M, Muttillo I, Petz WL, Pisano M, Guerrieri M, Silecchia G, Agresta F. Current status on the adoption of high energy devices in Italy: An Italian Society for Endoscopic Surgery and New Technologies (SICE) national survey. Surg Endosc 2020; 35:6201-6211. [PMID: 33155075 PMCID: PMC7644118 DOI: 10.1007/s00464-020-08117-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Accepted: 10/21/2020] [Indexed: 12/11/2022]
Abstract
Background In the past three decades, different High Energy Devices (HED) have been introduced in surgical practice to improve the efficiency of surgical procedures. HED allow vessel sealing, coagulation and transection as well as an efficient tissue dissection. This survey was designed to verify the current status on the adoption of HED in Italy. Methods A survey was conducted across Italian general surgery units. The questionnaire was composed of three sections (general information, elective surgery, emergency surgery) including 44 questions. Only one member per each surgery unit was allowed to complete the questionnaire. For elective procedures, the survey included questions on thyroid surgery, lower and upper GI surgery, proctologic surgery, adrenal gland surgery, pancreatic and hepatobiliary surgery, cholecystectomy, abdominal wall surgery and breast surgery. Appendectomy, cholecystectomy for acute cholecystitis and bowel obstruction due to adhesions were considered for emergency surgery. The list of alternatives for every single question included a percentage category as follows: “ < 25%, 25–50%, 51–75% or > 75%”, both for open and minimally-invasive surgery. Results A total of 113 surgical units completed the questionnaire. The reported use of HED was high both in open and minimally-invasive upper and lower GI surgery. Similarly, HED were widely used in minimally-invasive pancreatic and adrenal surgery. The use of HED was wider in minimally-invasive hepatic and biliary tree surgery compared to open surgery, whereas the majority of the respondents reported the use of any type of HED in less than 25% of elective cholecystectomies. HED were only rarely employed also in the majority of emergency open and laparoscopic procedures, including cholecystectomy, appendectomy, and adhesiolysis. Similarly, very few respondents declared to use HED in abdominal wall surgery and proctology. The distribution of the most used type of HED varied among the different surgical interventions. US HED were mostly used in thyroid, upper GI, and adrenal surgery. A relevant use of H-US/RF devices was reported in lower GI, pancreatic, hepatobiliary and breast surgery. RF HED were the preferred choice in proctology. Conclusion HED are extensively used in minimally-invasive elective surgery involving the upper and lower GI tract, liver, pancreas and adrenal gland. Nowadays, reasons for choosing a specific HED in clinical practice rely on several aspects, including surgeon’s preference, economic features, and specific drawbacks of the energy employed.
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Affiliation(s)
- Emanuele Botteri
- General Surgery, ASST Spedali Civili Di Brescia, Montichiari, Italy.
| | - Mauro Podda
- Department of Emergency Surgery, Azienda Ospedaliero-Universitaria Di Cagliari, Policlinico Universitario Di Monserrato "Duilio Casula" University of Cagliari, Cagliari, Italy
| | - Alberto Arezzo
- Department of Surgical Sciences, University of Torino, Turin, Italy
| | - Nereo Vettoretto
- General Surgery, ASST Spedali Civili Di Brescia, Montichiari, Italy
| | - Alberto Sartori
- Department of General Surgery, Ospedale Di Montebelluna, Montebelluna, Italy
| | - Antonino Agrusa
- Department of General and Emergency Surgery, University of Palermo, Palermo, Italy
| | | | - Gabriele Anania
- Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Ferrara, Italy
| | - Riccardo Brachet Contul
- Department of General and Emergency Surgery, Ospedale Regionale Umberto Parini, Aosta, Italy
| | | | - Elisa Cassinotti
- Chirurgia Generale, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Diego Cuccurullo
- Department of General Surgery, Ospedali Dei Colli Monaldi Hospital, Naples, Italy
| | - Giancarlo D'Ambrosio
- Department of General Surgery, Surgical Specialties and Organ Transplantation, Rome, Italy
| | - Marco Milone
- Department of Clinical Medicine and Surgery, Federico II University of Naples, Naples, Italy
| | - Irnerio Muttillo
- Department of General and Emergency Surgery, Ospedale San Filippo Neri, Roma, Italy
| | - Wanda Luisa Petz
- Department of Surgery, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Marcello Pisano
- Department of General Surgery, Ospedale San Marcellino di Muravera, Cagliari, Italy
| | - Mario Guerrieri
- Department of General Surgery, Università Politecnica delle Marche, Ancona, Italy
| | - Gianfranco Silecchia
- Department of Medico-Surgical Sciences and Biotechnologies, University La Sapienza of Rome, Latina, Italy
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