Computer-assisted electrocoagulation: Bipolar vs. monopolar in the treatment of experimental canine gastric ulcer bleeding

Abstract

A prospective, randomized, controlled experiment using a canine model of severely bleeding gastric ulcer was performed to compare the hemostatic efficacy and tissue damage produced by one bipolar and two monopolar electrodes. Both monopolar electrodes were insulated to their tips; they differed with respect to their surface area (3 mm2 vs. 4 mm2). The force of electrode application was controlled. An analog computer monitored the energy per electrode application and predetermined the duration of each application. Fifty-nine standard acute bleeding ulcers were made and treated one at a time in six heparinized foxhounds at sterile laparotomy. Treatment was randomized to the bipolar or to one of the monopolar electrodes within each of three bleeding strata. No significant difference was observed in hemostatic efficacy among the three electrodes. Treated ulcers were examined histologically after 5 to 7 days to determine the maximum tissue damage produced: Bipolar electrocoagulation caused significantly less damage than electrocoagulation with either monopolar electrode. We conclude that with these electrodes, bipolar electrocoagulation is equally effective for stopping bleeding but results in less tissue injury than monopolar electrocoagulation in this experimental model.