Since 2002, Randall Michel, M.D., FACS and Bernard Weinstock, M.D. have used Starion's ENTceps™ to safely and effectively seal and cut tissue during a wide range of ENT procedures. ENTceps features the company's patented Tissue Welding technology, which focuses thermal energy to simultaneously seal and divide soft tissue. Michel and Weinstock found that by using ENTceps in place of an electrocautery device during ENT procedures, they were able to avoid inadvertent damage to adjacent tissue and nerves.

Back in 2002, Randall Michel, M.D., FACS, Bernard Weinstock, M.D. and their colleagues at Lompoc Valley Medical Center in Lompoc, CA were interested in ways to improve the efficacy of electrocautery devices used to seal and cut tissue during ENT procedures.

"Patient safety is a primary concern. We wanted to continuously monitor major motor nerves during various head and neck surgical procedures in order to avoid inadvertent nerve injury," said Michel. "The standard electrocautery devices prevented us from doing this since most automatically disable the nerve monitor every time the device is activated."

According to Michel, the standard electrocautery devices also increased the risk of collateral tissue damage during procedures, which can lead to higher post-operative pain scores, particularly in patients who have undergone tonsillectomies.

"Collateral tissue damage in tonsillectomy correlates with increased post-operative pain," said Michel. "If you cut tissue with an electrocautery device, the resulting thermal spread can damage structures beyond what you've actually touched. Sometimes you get damage that you can't see."

Lastly, most electrocautery devices are activated by a single switching mechanism, such as a foot pedal. This presented a number of potential hazards in the operating room.

"All you have to do is hit one button to activate the electrocautery," said Michel. "If someone sets the device down on the patient and accidentally hits the foot pedal, then an injury can occur to the patient or operators."

Michel's colleague, Bernard Weinstock, M.D., learned of Starion Instruments in late 2002 and he and Michel began using Starion's ENTceps™ for tonsillectomies and parotidectomies. Unlike conventional products employing monopolar, bipolar or ultrasonic energy, ENTceps features Starion's patented Tissue Welding technology, using direct heat and pressure to simultaneously seal and divide soft tissue. According to Michel, ENTceps was a big improvement over existing technology.

"The first thing that we noticed with the Starion device was that there was no tissue charring adjacent to the instrument. Temperature measurements adjacent to the forceps indicated less thermal spread, making it possible to use the ENTceps closer to adjacent nerves and blood vessels," said Michel. "Also, what you pinch with the forceps is what you cut and seal."

With Starion's technology, no electrical current is required to pass through the patient, so it is compatible with other instrumentation and devices, including nerve monitors. This enables Michel, Weinstock and their team to continuously monitor nerves during procedures, enhancing patient safety.

"Nerve monitoring has become the standard of care and with Starion's device we can now continuously monitor all major motor nerves, including the recurrent laryngeal nerve during thyroid surgery and the spinal accessory nerve during neck dissections. That's a major benefit for us," said Michel.

All of Starion's instruments also feature built-in safety mechanisms to protect patients and OR staff from inadvertent injury. "You have to apply pressure to the forceps and depress the foot pedal in order to activate it, so there is much less chance of inadvertent activation," said Michel.

Because of its effectiveness, safety, reliability and flexibility, Michel and Weinstock now use Starion's ENTceps across all of their ENT procedures, including thyroids, parotids, parathyroids, tonsillectomies, and selective neck dissection cases.

"We're still very pleased with the use of ENTceps six years later," said Michel.

Michel, Weinstock and their colleagues are currently conducting an ongoing, double blind study comparing the various seal and cut modalities for ENT procedures, including Starion's Tissue Welding technology.