Experimental evaluation of a novel low temperature plasma surgical system on porcine liver and spleen

Objective To evaluate effectiveness and safety of a new surgical system which applies low temperature plasma (NTS-100) in the liver and spleen surgeries. Methods Twelve piglets were randomly divided into three groups, and they underwent operations using NTS-100, Valley or PEAK surgical systems, respectively. The advantages and disadvantages of these three devices in terms of cutting, coagulation, thermal injury necrosis were evaluated with the indexes of local working temperature, blood loss, region of coagulation necrosis, operation fluency. Results There was no statistically significant difference in the amount of bleeding among three electrosurgical devices in liver surgeries (P＞ 0.05). In spleen surgeries, the amount of bleeding produced by NTS-100 coagulation mode was statistically significantly less than those by the Valley and PEAK (0.762±0.290) g vs (1.170±0.364) g, (1.233±0.454) g, P＜ 0.05, respectively, however, in the cutting mode, there was no statistically significant difference (P＞ 0.05). The local temperatures of liver and spleen in the cut and coagulation mode of NTS-100 were statistically significantly lower than those of Valley temperature as liver cutting: (75.3±6.1)℃ vs (204.6±20.5)℃; temperature as liver coagulated: (195.8±15.4)℃vs (272.3±26.6)℃; temperature as spleen cutting: (69.4±11.1)℃ vs (226.8±30.0)℃; temperature as spleen coagulated: (199.8± 16.9)℃ vs (267.8±42.5)℃, P＜ 0.01, respectively, and it was also lower than that of PEAK with no statistically significant difference (P＞ 0.05). The width of acute heat injury by NTS-100 to liver and spleen was statistically significantly less than that of Valley (P＜ 0.05), but not different with PEAK (P＞ 0.05). The cutting sharpness of NTS-100 to soft tissue was superior to Valley and PEAK. The scab adhered to NTS-100 was less and it was easier to fall off than Valley. Conclusion Local working temperature of this new surgical system which applies low temperature plasma (NTS-100) is significantly lower than Valley, and comparable with PEAK. The coagulation effect to liver and spleen as using NTS-100 is better than PEAK and Valley. The sharpness to soft tissue as using NTS-100 is greater than PEAK and Valley, and the operation fluency is also better as using NTS-100.