Comparison of the effects of surgical dissection devices on the rabbit liver
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Multiple energy-based surgical dissection and coagulation modalities are available to facilitate surgical dissection and hemostasis, but there is limited information regarding the acute tissue effects of these devices. Our objective was to compare the functional characteristics and tissue effects of four energy-based surgical dissection and coagulation modalities on the rabbit liver.
Linear incisions were created in the rabbit liver using monopolar electrocautery, a harmonic scalpel, a PlasmaBlade and a new ferromagnetic induction loop device. Subjective cutting and coagulation characteristics for each device were recorded, and the histological tissue effects were evaluated.
Each of the modalities successfully incised the liver tissue. The PlasmaBlade and the ferromagnetic induction loop exhibited significantly less perceived tissue drag during the incision, significantly less collateral tissue damage and significantly better margin uniformity than the monopolar electrocautery device. Each device showed comparable subjective hemostasis. The harmonic scalpel did not demonstrate a significant difference compared with any of the other devices in any of the parameters examined. The histological analysis revealed that the least lateral thermal damage resulted when the PlasmaBlade, harmonic scalpel and ferromagnetic induction loop were used, and the most damage occurred with the use of monopolar electrocautery.
Each of the newer energy-based surgical tools showed improvement over monopolar electrocautery with regard to lateral thermal injury, and the ferromagnetic induction device and the PlasmaBlade demonstrated superior surgical tissue handling characteristics to the monopolar electrocautery device.
KeywordsMonopolar electrocautery Harmonic scalpel PlasmaBlade Ferromagnetic induction loop Cautery Electrosurgical device
- 5.Homayounfar K, Meis J, Jung K, Klosterhalfen B, Sprenger T, Conradi LC, Langer C, Becker H. Ultrasonic scalpel causes greater depth of soft tissue necrosis compared to monopolar electrocautery at standard power level settings in a pig model. BMC Surg. 2012;12:3.PubMedCentralPubMedCrossRefGoogle Scholar
- 9.Ruidiaz ME, Messmer D, Atmodjo DY, Vose JG, Huang EJ, Kummel AC, Rosenberg HL, Gurtner GC. Comparative healing of human cutaneous surgical incisions created by the PEAK PlasmaBlade, conventional electrosurgery, and a standard scalpel. Plast Reconstr Surg. 2011;128:104–11.PubMedCrossRefGoogle Scholar
- 10.Gruber DD, Warner WB, Lombardini ED, Zahn CM, Buller JL. Laparoscopic hysterectomy using various energy sources in swine: a histopathologic assessment. Am J Obstet Gynecol. 2011;205:494.e491–6.Google Scholar
- 11.Schoinohoriti OK, Chrysomali E, Iatrou I, Perrea D. Evaluation of lateral thermal damage and reepithelialization of incisional wounds created by CO(2)-laser, monopolar electrosurgery, and radiosurgery: a pilot study on porcine oral mucosa. Oral Surg Oral Med Oral Pathol Oral Radiol. 2012;113:741–7.PubMedCrossRefGoogle Scholar