Since 2001, Hendrick B. Barner, M.D. and his cardiothoracic surgery team at St. Louis University have used Starion's Cautery Forceps to seal and cut tissue and vessels during radial artery harvesting procedures. Barner found that by using Starion's Tissue Welding technology in place of clips, electrocautery and the Harmonic Scalpel, he could reduce procedure times and minimize the risk of inadvertent injury to the radial artery and adjacent nerves.

Radial artery harvesting for coronary artery bypass graft (CABG) surgery saw a resurgence in the early 1990s as surgeons sought alternatives to saphenous vein and internal thoracic (mammary) artery grafts.

Hendrick B. Barner, M.D. from the Division of Cardiothoracic Surgery at St. Louis University and his team began using the radial artery as a conduit for CABG surgery back in 1993, but they faced a number of challenges when it came to coagulating vessels and dividing soft tissue during harvesting procedures.

"We didn't want to use electrocautery since the heat can spread and injure the vessel or nearby nerves," said Barner. "So we had to deal with the branches of the radial artery by an alternative method."

Barner and his team turned to clips as a solution since they were the standard at the time, but found that they were inefficient.

"The clips worked fine but the radial artery has a lot of branches," said Barner. "We'd pick up the clipping instrument, apply two clips, lay it down, pick up a pair of scissors, cut in between the clips and then repeat this same sequence 20 times during the course of a procedure."

Seeking a more efficient solution, they began using the Harmonic Scalpel, but this too had its limitations.

"A few people were using the Harmonic Scalpel to dissect the chest artery but abandoned it because it was so large and bulky," said Barner. "We started using it on the arm and it was faster than using the clips but some of the branches would bleed."

In 2001, Barner learned of Starion Instruments and decided to try the company's Cautery Forceps in a radial artery harvesting procedure. Unlike conventional products employing monopolar, bipolar or ultrasonic energy, Starion's Cautery Forceps feature the company's patented Tissue Welding technology, which uses direct heat and pressure to simultaneously seal and divide soft tissue and vessels. Barner found that the Starion device was a vast improvement over the devices that he had previously used.

"We got one of the surgical assistants to give it a try and he liked it," said Barner. "I used it as well and we all found that it was faster and easier to use than the Harmonic Scalpel and the clips, plus it sealed better. Furthermore, it was effective in not only dividing the branches, but also in dividing the other tissue around the radial artery."

Over the past seven years, Starion's Cautery Forceps have become Barner's preferred instrument for radial artery harvesting based on its safety, efficacy and ease of use. According to Barner, Starion's device does not cause any injury to the radial artery or nearby nerves and it has not been associated with bleeding from the branches.

"We've gone through three evolutions — clips, Harmonic Scalpel and now Starion's Cautery Forceps — and Starion's technology has been the most efficient, safe and effective solution," said Barner.