With the rapid advancement of technologies such as microprocessors and sensors, electrosurgical techniques in the medical field have also seen significant improvement. In electrosurgery, large vessel sealing technology is a revolutionary development. Currently, LigaSure-type large vessel sealing devices dominate the market. Among them, ShouLiang-med’s AGISEAL series stands out for its excellent performance and has received widespread acclaim both domestically and internationally. These devices are now widely used in clinical surgical procedures.

 

In thyroid surgery, the use of energy devices has improved both safety and precision. However, the choice of energy device is a critical consideration for surgeons. Different types of energy devices have their own applications, advantages, and limitations at various stages of surgery—for example, ultrasonic energy devices versus large vessel sealing devices.

 

Ultrasonic energy devices convert electrical energy at 55.5 kHz into mechanical energy via piezoelectric ceramics. The mechanical vibration is transmitted to the tissue through the blade, causing high-frequency friction. This results in vaporization of water molecules, breakdown of protein hydrogen bonds, cell disruption, tissue separation, protein denaturation, and vessel coagulation. Approved by the U.S. FDA, ultrasonic scalpels can safely seal vessels with diameters under 5 mm. While these devices feature lightweight, compact, and flexible curved-tip designs and are increasingly used in thyroid surgery, it’s important to note that their higher operating temperatures can lead to significant lateral thermal spread—especially near the recurrent laryngeal nerve—posing a risk of postoperative complications due to nerve damage.

 

Traditional monopolar and bipolar energy devices typically seal vessels by forming an intraluminal coagulum and rely solely on visual cues for energy control. These devices lack a feedback mechanism to monitor output power and impedance, making it difficult to gauge optimal coagulation power and duration.

 

ShouLiang-med’s independently developed AGISEAL series of advanced energy devices addresses these shortcomings by incorporating a negative feedback detection system. Using enhanced bipolar pressure, AGISEAL denatures and fuses the collagen and fibrin in blood vessels, permanently sealing the lumen. AGISEAL can seal vessels with diameters less than 7 mm, and the sealed vessels can withstand arterial pressures up to three times the normal human level. Additionally, it operates at a lower temperature and produces minimal lateral thermal damage, effectively protecting the recurrent laryngeal nerve and reducing the risk of complications.

 

With intelligent feedback that accurately senses tissue coagulation levels and precisely regulates optimal coagulation power and time, AGISEAL maximizes surgical safety and has become the preferred energy device for thyroid surgery.

Hemorrhoids are a common anal disease, with 10% to 20% of patients requiring surgical treatment ^[1]. Common issues with traditional hemorrhoidectomy are postoperative bleeding and pain. The Agiseal electrosurgical vessel sealer divider, a novel tissue-cutting and coagulating device, brings significant improvements to hemorrhoid surgery.

 

Agiseal,independently developed by ShouLiang-med, uses advanced real-time feedback and intelligent generator technology. By delivering high-frequency electrical energy combined with constant pressure between the jaws, it causes denaturation of collagen and fibrin within the target vessels. It fuses the vessel walls, forming a transparent band that achieves permanent lumen closure. Its advantages include: no need for excessive separation during closure, and faster closure speed; no smoke, maintaining a clear surgical field; and low local temperatures, minimizing damage to surrounding tissues. According to reports ^[2], the United Kingdom has successfully applied electrosurgical vessel sealer divider in haemorrhoidectomy procedures, achieving excellent haemostasis outcomes and significantly reducing postoperative pain in patients. 

 

Traditional mixed hemorrhoidectomy is often associated with significant bleeding, which not only prolongs surgery time but also obscures the surgical field and reduces procedural accuracy. Conventional haemostasis methodssuch as ligation or electrocoagulation are also prone to causing collateral damage to surrounding tissues, thereby delaying wound healing. The application of the electrosurgical vessel sealer divider allows for pre-closure of haemorrhoidal tissue vessels prior to excision., resulting in minimal bleeding during excision along the closure zone. Furthermore, this technique eliminates the need for conventional suture ligation of the stump, simplifying the procedure and shortening operative time. Its core principle (inducing fibrin deformation and coagulation) also ensures safe and reliable hemostasis ^[3].

 

In traditional surgery, suture ligation of the hemorrhoidal pedicle tissue easily triggers sphincter spasm, leading to severe postoperative pain.  The Agiseal hemorrhoidectomy does not require ligation of the haemorrhoidal tissue, thereby reducing the incidence and intensity of postoperative pain from the source. Additionally, the sealing process causes minimal thermal damage to surrounding tissues, effectively avoiding burns and tissue edema caused by the thermal effects of electrocautery. Postoperative pain is typically controlled with oral medications alone, significantly reducing discomfort and minimizing the risk of drug side effects ^[4].

 

Benefiting from advantages such as minimal intraoperative bleeding, minimal tissue damage, and milder postoperative pain, patient recovery is accelerated, and hospital stays are significantly shortened. Although the single-use cost of the electrosurgical vessel sealer divider may be higher than traditional instruments, preliminary statistics show that the overall hospitalization costs for patients do not increase significantly,which may be mainly attributed to the effective reduction in the number of hospital days ^[3].

 

In summary, for patients with grade III to IV mixed hemorrhoids, the use of electrosurgical vessel sealer divider for hemorrhoidectomy is more advantageous than traditional hemorrhoid surgery in terms of reducing intraoperative blood loss and shortening hospital stay ^[3]. Its precise, efficient, and minimally invasive characteristics provide patients with a more comfortable and faster recovery experience.

 

 

Reference:

[1] BLEDAY R，PENA JP，ROTHENBERGER DA，et al.Symptomatic hemorrhoids: current incidence and compli -cations of operative surgery［J］.Dis Colon Rectum，1992，35（5）:471-481.

[2] PALAZZO FF，FRANCIS DL，CLIFTON MA. et al. Randomized clinical trial of Ligasure versus open haemorrhoid -ectomy［J］. Br J Surg，2002，89（2）:154-157．

[3] Wang Zhanjun, Jia Shan, Wang Zhengliang,et al.A Comparative Study of Hemorrhoidectomy with Ligasure Technique and Milligan-Morgan Surgery［J］.Journal of Colorectal & Anal Surgery,2017,23(04):477-480.

[4] NIENHUIJS SW， DE HINGH IH. Pain after conventional versus Ligasure haemorrhoidectomy.A meta -analysis［J］.International Journal of Surgery，2010，8（4）:269-273.

Yu Juan and An Yani from Yantai Yuhuangding Hospital in Shandong Province published an article titled "Advantages of double-circuit Return Electrode Plates in High Frequency Generator" in the *Journal of Qilu Nursing*. The article mentioned that high frequency generator heats the tissues when it comes into contact with the body through the high-frequency and high-voltage electric current generated by the tip of the effective electrode, which achieves the separation and coagulation of the tissues of the body and thus serves the purpose of cutting and hemostasis.  Due to the physical properties of electrical currents, the current acting on the human body must return to the high frequency generator via the return electrode plate to form a complete circuit.

 

The return electrode plate (also known as the neutral or dispersed electrode) is a critical component used in electrosurgery in conjunction with the High Frequency Generator. Its primary purpose is to establish a safe circuit for the electric current, to ensure that the high-frequency current from the monopolar electrode through the patient's body can be safely returned to the generator, to avoid accidental burns. Its core functions include the most basic to provide a low-impedance path for high-frequency current to form a closed circuit, preventing the current from spreading in the body in an uncontrolled manner; secondly, reducing current density by increasing contact area, thereby minimizing localized temperature rises and lowering the risk of thermal tissue damage.  

 

The Disposable Patient Return Electrod provided by ShouLiang-med is professionally designed with key performance advantages to ensure surgical safety:

 

1.Excellent flexibility and strong adhesion ensure a stable and effective contact area between the patient and the electrode during surgery.

2.The conductive foil in the center is evenly divided into two sections. Once applied to the skin, the return electrode monitoring system in the high-frequency surgical device continuously evaluates the contact status. If any abnormality is detected, the system will trigger an audio-visual alarm and automatically stop output, ensuring real-time monitoring of effective patient connection.

3.With nearly zero resistance and low thermal effect, the electrode features a rounded rectangular shape that promotes even heat distribution, significantly reducing the risk of burns.

4.Designed for single use, it prevents cross-contamination between surgical patients and greatly enhances procedural safety.

In modern clinical surgery, advancements in tissue dissection and hemostatic technologies are key to improving safety and efficiency. The application of large vessel sealing systems, combined with dedicated surgical instruments, has significantly enhanced procedural outcomes and represents a major technological breakthrough in the field.

 

Large vessel sealing systems use real-time feedback and intelligent energy platforms to deliver high-frequency current with consistent pressure at the jaws. This causes collagen and elastin in vessel walls to denature and fuse, forming a clear, permanent seal. The system can seal vessels up to 7mm in diameter, requires minimal dissection, offers fast activation, produces no surgical smoke, and minimizes thermal spread to surrounding tissues.

 

Due to high technical barriers, few companies have achieved true innovation in this domain. ShouLiang-med’s SL100M large vessel sealing system is a leading example. Equipped with proprietary tissue-sensing technology, it continuously monitors tissue impedance to precisely adjust energy output, ensuring safe, efficient, and complete sealing of vessels under 7mm.

 

Relevant literature indicates that Wu Zeyu et al.^[1] applied large vessel sealing system in radical gastrectomy and found that major gastric vessels, including the left gastric artery and gastroduodenal artery, could be transected using the sealing system without suture ligation. Wu Baoqiang et al.^[2] found that large vessel sealing system applied in surgery for benign thyroid diseases could simplify the surgical procedure, reduce operative time, and decrease intraoperative blood loss. A systematic review was performed on seven randomized controlled trials by Janssen et al.^[3], its results show that large vessel sealing system is more effective than other electrosurgical or ultrasonic devices in reducing intraoperative bleeding and shortening operative time.

 

In conventional partial small intestine resection, mesenteric vessels must be dissected and ligated. The mesentery contains a dense vessel network with numerous delicate branches that are prone to bleeding. Both ends of the intestine must be clamped before transection. Directly transecting mesentery with large vessel sealing system avoids repeated dissection and ligation of vessels, simplifying the surgical procedure. Furthermore, using large vessel sealing system to directly transect the intestine prevents intestinal leakage, which helps to shorten the operative time.

 

In conclusion, using large vessel sealing system in partial small intestine resection could simplify the procedure, shorten operative time, and reduce bleeding.

 

References：

［1］Wu Zeyu, Yao Yuan, Wan Jin, et al. Application of LigasureTM vessel sealing system in radical D2 surgery for gastric cancer[J]. Chinese Journal of Gastrointestinal Surgery,2008,11 ( 2 ) :184 － 185.

［2］Wu Baoqiang, Chen Weibo, Jiang Yong, et al. Application of LigaSure vessel sealing system in surgery for benign thyroid diseases [J]. Chinese Journal of General Surgery, 2016, 25 ( 11) :1585 － 1589.

［3］ JANSSEN P F，BＲLMANN H A，HUIＲNE J A． Effectiveness of electrothermal bipolar vessel － sealing devices versus other electrothermal and ultrasonic devices for abdominal surgical hemostasis: a systematic review［J］． Surg Endosc，2012，26( 10) : 2892 － 2901．

In recent years, electrosurgical vessel sealers/dividers have gained widespread recognition in the field of surgery due to their unique benefits. But what makes them so compelling? Let’s explore the five key clinical advantages that set them apart.

 

1. Minimally Invasive and Tissue-Sparing

One of the most notable advantages of electrosurgical vessel sealers/dividers is their ability to facilitate minimally invasive procedures through small incisions. This not only reduces patient pain and minimizes scarring but also significantly shortens recovery time. Moreover, smaller incisions lower the risk of infections and other postoperative complications, enhancing overall surgical outcomes.

 

2.Easy to Use

The electrosurgical vessel sealer/divider is designed with user-friendliness in mind, ensuring that even less experienced surgeons can operate it with ease. With minimal training requirements, it seamlessly integrates into various surgical workflows without disruption. 

 

3. High Efficiency & Time-Saving

Compared to conventional surgical techniques, the electrosurgical vessel sealer/divider significantly reduces procedure time. By simultaneously sealing and dividing vessels, it enables surgeons to perform operations more efficiently, alleviating stress for both patients and surgical teams, minimizing the risk of complications, and shortening hospital stays.

 

4.Precise Treatment

Electrosurgical Vessel Sealer/ Divider demonstrate exceptional maneuverability, accuracy, and precision during surgery. They are capable of sealing blood vessels with minimal damage to surrounding tissues, effectively reducing the risk of bleeding, bruising, and other complications.

 

5.Cost-Effective

    Although the initial investment in Electrosurgical Vessel Sealer/ Divider instruments may be higher compared to traditional surgical techniques, they are more cost-effective in the long run. The reduction in surgery time and shorter hospital stays significantly lowers overall costs for both patients and healthcare institutions.