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Research Papers

An Experimental Study on Bipolar Tissue Hemostasis and Its Dynamic Impedance

[+] Author and Article Information
Xiaoran Li

Department of Mechanical Engineering,
The University of Texas at Austin,
Austin, TX 78712

Roland Chen

School of Mechanical and Materials Engineering,
Washington State University,
Pullman, WA 99164

Wei Li

Department of Mechanical Engineering,
The University of Texas at Austin,
Austin, TX 78712
e-mail: weiwli@austin.utexas.edu

1Corresponding author.

Manuscript received October 27, 2017; final manuscript received February 25, 2018; published online April 2, 2018. Editor: Y. Lawrence Yao.

J. Manuf. Sci. Eng 140(6), 061016 (Apr 02, 2018) (8 pages) Paper No: MANU-17-1667; doi: 10.1115/1.4039493 History: Received October 27, 2017; Revised February 25, 2018

Bipolar tissue hemostasis is a medical procedure where high frequency alternating current is applied to biological tissue for wound closing and blood vessel sealing through heating. The process is often performed with a set of laparoscopic forceps in a minimal invasive surgery to achieve less bleeding and shorter recovery time. However, problems such as tissue sticking, thermal damage, and seal failure often occur and need to be solved before the process can be reliably used in more surgical procedures. In this study, experiments were conducted to examine process parameters and the dynamic behavior of bipolar heating process through electrical impedance measurements. The effects of electrode compression level, heating power, and time are analyzed. Heating energy and bio-impedance are evaluated for quality prediction. Tissue sticking levels were correlated to the size of denatured tissue zone. It is found that tissue denaturation starts from the center of the heated region. Dynamic impedance reveals the stages of tissue hemostasis process. However, it is strongly affected by the compression level and heating power. Existing criteria for quality prediction and control using the heating energy and minimal impedance are not reliable. The size of denatured tissue zone can be predicted with the heating energy; however, the prediction is strongly dependent on the compression level. To avoid sticking, a low power and low compression level should be used for the same denatured tissue zone size.

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Figures

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Fig. 2

Denatured tissue zone marked on an image of a tissue sample after heating

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Fig. 1

(a) A schematic of the experimental setup and (b) the first 2 ms of voltage signal under the 35 W power setting

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Fig. 3

Plots of denatured tissue zone with time under different (a)–(c) compression level and (d)–(f) power settings

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Fig. 6

The relationship of denatured tissue volume and heating energy

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Fig. 7

Dynamic impedance correlated with quality of bipolar tissue hemostasis

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Fig. 8

(a)–(c) Resistance plot with different compression levels under 25 W, 35 W, and 45 W power settings; (d)–(f) Resistance with different power settings under 25%, 50%, and 75% compression levels

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Fig. 9

Sticking level and denatured tissue zone size as affected by heating power and compression level

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Fig. 4

Lobe plots for acceptable denatured zone size as a function of time

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Fig. 5

The relationship between denatured tissue zone size and heating energy

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