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Histologic characteristics of laparoscopic saline-enhanced electrosurgery of liver and splenic injuries

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Abstract

Background: Hemostasis is crucial during laparoscopic surgery. Unlike conventional electrosurgery, saline-enhanced electrosurgery (SEE) improves the electrode-to-tissue interface. This study investigated SEE as a means of achieving hemostasis in liver and splenic injuries and assessed the associated histologic changes. Methods: Nine anesthetized pigs underwent laparoscopic liver tip and splenic wedge amputations. Injuries were treated with SEE (25–35 and 35–45 W, respectively). Animals were sacrificed postprocedure and at 1 and 4 weeks. Depth of necrosis was analyzed using a mixed model analysis of variance. Results: Liver mean depth of necrosis was 5.3 mm (acute), 6.0 mm (1 week), and 5.3 mm (4 weeks) (p = not significant). Splenic mean depth of necrosis was 7.0 mm (acute), 7.0 mm (1 week), and 2.7 mm (4 weeks). (p < 0.01) Acute injuries demonstrated thermal coagulation necrosis that healed with well-defined bands of collagen at 1 and 4 weeks. Conclusions: SEE provides effective hemostasis and results in an acceptable depth of necrosis with satisfactory wound healing in a porcine model of solid organ injury.

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Acknowledgements

We thank Ulla Wallin, Perry De Fazio, and Jeffery Pettit for their technical expertise and assistance with this project. This study was funded in part by TissueLink Medical (Dover, New Hamshire, USA)

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Authors and Affiliations

  1. Department of Surgery, Massachusetts General Hospital, 55 Fruit Street, Hurlbut Room, Boston, MA 02214, USA

    C. Sims & N. Stylopoulos

  2. University of Pittsburgh Medical Center, Presbyterian F1265, 200 Lothrop Street, Pittsburgh, PA 15213, USA

    J. Clavijo

  3. Harvard Center for Minimally Invasive Surgery, SG Mudd Building B041, 250 Longwood Avenue, Boston, MA 02115, USA

    C. Barlow

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  1. C. Sims
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  2. N. Stylopoulos
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  3. J. Clavijo
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  4. C. Barlow
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Correspondence to C. Sims.

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Sims, C., Stylopoulos, N., Clavijo, J. et al. Histologic characteristics of laparoscopic saline-enhanced electrosurgery of liver and splenic injuries . Surg Endosc 17, 1739–1743 (2003). https://doi.org/10.1007/s00464-002-8638-8

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  • DOI: https://doi.org/10.1007/s00464-002-8638-8

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