sealer demo

In this case, we're using the sealer to take down the mesentery of an intestinal duplication. Initially, a hole is made in the mesentery using the sealer simply by sealing the vessels and dissecting underneath the anti-mesentery. Border to allow for placement of the 5 millimeter stapler. Once the bough is divided, we simply grab the mesentery, seal it, and gently distract it away from the cyst. This is the technique we use in all bowel resections, and it works quite effectively. Vessels which are seen clearly here, each individually isolated, grasped with the sealer, sealed, and then retracted away from the bow. This is a very safe and efficient technique for mobilizing the distant bowel without devasculararizing it. It is also much safer than using electrocautery in this area which could spread to surrounding structures causing injury to the vast deferences, the bladder, the ureter, and other structures. Could also damage the in here. Again, the ability to dissect and then seal and distract the tissues away from the colon, uh, provides a very safe and efficient technique. This dissection is carried down towards the fistula. In this case, it's a thicker plane, and once we've done so, we can use the 3 millimeter sealer again to help. Seal and separate these tissues. In this case, we were performing a niss and fundoplication on a child who had previous perforated NEC. Because of that, there are significant adhesions in the upper abdomen from the inflammation. Here you can see we're trying to approach the short gastric vessels. We create a window in the along the greater curvature. And then get into the plane where we enter the lesser sack. We're then able to seal the short gastric vessels and gently separate them apart without the need for using a scissor. These vessels are 1 to 2 millimeters in size and are perfect for creating a double seal and then distracting the vessels apart. This allows us to use both hands for retraction at all times. It would have been extremely difficult to do this maneuver, having to interchange for a scissor or having an instrument which could not readily manipulate these small and delicate tissues. However, you can see that we easily have control of both the stomach and the spleen, and can seal and separate the short gastrics with little trauma to surrounding tissues. This was key in this particular infant who weighed only 2.5 kg at the time of this procedure. The same technique can be used, and lastly, we use the sealer in a case of Hirschsprung's disease where we simply are dissecting the mesentery right off the bow wall. This is again a very safe and efficient technique.