Andres Vigueras Smith, Monica Tessmann Zomer Kondo, William Kondo, Ramiro Cabrera, Brazil
The present review aims to analyze the current information on basic principles, applications, advantages and risks of the main surgical devices used in laparoscopic surgery. A comprehensive review of literature was made of existing english language publications on databases Pub med and Google Scholar following a Mesh and key word searching. The studies were finally selected by one author according to the aim of this review. Currently, different kinds of devices using electrical, mechanical, plasma and ferromagnetic heat energy are available in laparoscopic surgery. New advanced bipolar instruments, using a tissue impedance measure, vessel sealing technologies and positive temperature control allows the surgeon an effective, safe and faster surgery, with less thermal spread. Ultrasound apply to surgery offer the surgical team (using a combination of high speed mobilization and cavitation principles) a faster and safest surgery parameters, but with the highest device tip heating. Thunder beat' is a unique instrument that combines the cutting efficiency of the ultrasound with the coagulation advantages of bipolar energy, and appears to be the fastest and more versatile device available. Using ionized inner gas with minimal electricity flow, plasma devices allows cutting, coagulation and fulguration in the same instrument, but probably with the higher thermal spread among all. Employing pure thermal heat due the conduction of radio-frequency current, ferromagnetic heat energy devices are the newest instruments that can safety seal vessels up to 7 mm.