Abstract
BackgroundWe aimed to determine the optimal bipolar electrocoagulation power for laparoscopic surgery and to investigate which method, bipolar electrocoagulation, advanced bipolar, or ultrasonic technique was more reliable.MethodsGoat mesenteric vessels (210 in vivo samples) with diameters of 3.03–5.44 mm were selected. Bipolar electrocoagulation with 80 W, 75 W, 70 W, 65 W, 60 W, 55 W, and 50 W, and advanced bipolar and ultrasonic techniques were performed on mesenteric vessels. The thermal damage width, hemostatic effect, and burst pressure of these tissues were recorded. SPSS version 13.0 was used for all data analysis.ResultsThe results showed that 60 W was the optimal for bipolar electrocoagulation based on the thermal damage width, hemostatic effect, and burst pressure. In contrast, the thermal damage width of advanced bipolar and ultrasonic techniques was smaller than that of bipolar electrocoagulation, and advanced bipolartechnique had the highest successful rate for hemostasis and highest burst pressure.ConclusionsBipolar electrocoagulation was optimally performed with 60 W of power. Compared with ultrasonic and bipolar electrocoagulation techniques, advanced bipolar use was more reliable for mesenteric vessels in laparoscopic surgery; however, bipolar electrocoagulation with optimal power can be used for its simplicity of operation and low cost.
Highlights
We aimed to determine the optimal bipolar electrocoagulation power for laparoscopic surgery and to investigate which method, bipolar electrocoagulation, advanced bipolar, or ultrasonic technique was more reliable
There was no significant not statistically significant at 50 W compared with 65 W and 70 W (P = 1.000), and thermal damage width was similar for these 3 groups (Table 2)
We studied the thermal damage to mesenteric vessels and hemostatic effects in goats using bipolar electrocoagulation at different powers, and the thermal damage and hemostatic effect of bipolar electrocoagulation, advanced bipolar device, and ultrasonic device were compared
Summary
We aimed to determine the optimal bipolar electrocoagulation power for laparoscopic surgery and to investigate which method, bipolar electrocoagulation, advanced bipolar, or ultrasonic technique was more reliable. Owing to the quest for more efficient and safer hemostatic techniques in laparoscopic surgery, several coagulating techniques and devices have been developed, including bipolar electrocoagulation, advanced. LBipolar electrocoagulation is still widely used in laparoscopic surgery because of its simplicity of operation and low cost [2, 3]. Several studies suggested that LigaSure and plasma knife devices caused only minor thermal damage and had better hemostatic effects [4–6]. LHowever, some surgeons are unaware of the thermal damage caused by bipolar electrocoagulation and use of LigaSure, and Ultracision devices. Lack of skilled operation can result in vessel bleeding at the site of coagulation during and after surgery, leading to ureter, bladder, and bowel damage.
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