An Innovative Surgical Generator for Multiple Energy Modalities

Background: Electrosurgery has evolved significantly since its inception, with advancements in generator technology improving safety and efficacy. This study evaluates the performance and usability of the Dualto Energy System, a new multi-modal surgical energy platform combining core electrosurgery with enhanced monopolar, advanced bipolar, and ultrasonic capabilities. Methods: Benchtop testing assessed vessel sealing strength and thermal spread of Dualto compared to existing electrosurgical generators (GEN11 and MEGEN1) using various energy modalities and devices. Waveform and energy analysis was used to confirm electrical isolation of Dualto generators in expanded configuration. Preclinical studies evaluated hemostasis, thermal damage, and tissue healing in acute and chronic animal models. Surveys were conducted with surgeons, nurses, and biomedical technicians to assess usability and perceived benefits. An acquisition cost calculator was developed to estimate potential cost savings associated with Dualto implementation. Results: Benchtop testing demonstrated non-inferior vessel burst pressure for Dualto compared to GEN11. Thermal spread was comparable between generators, with slight increases observed in specific Dualto monopolar modes. Waveform analysis confirmed electrical isolation of Dualto generators. Dualto exhibited significantly faster frequency lock and transection speeds for ultrasonic devices. Preclinical studies demonstrated non-inferior hemostasis and thermal damage profiles for Dualto in both single and expanded configurations. Chronic preclinical studies met success criteria for hemostasis and tissue healing. HCP survey results indicated positive user perceptions regarding Dualto usability, efficiency, and potential cost savings. The cost calculator projected potential annual savings through reduced operating room time and maintenance. Conclusion: The Dualto Energy System demonstrates comparable or improved performance across multiple energy modalities compared to existing systems. Its modular design, combined with positive user feedback and potential cost savings, suggests that Dualto will be a useful addition to surgical energy technology in the operating room.