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Journals / Türk Üroloji Dergisi/Turkish Journal of Urology / 2009 / Cilt: 35 - Sayı: 3

Evaluation of thermal spread during the application of laparoscopic bipolar and ultrasonic devices

Laparoskopik bipolar ve ultrasonik enerji aletlerinin kullanımındaki termal yayılımın değerlendirilmesi

Asıf YILDIRIM
Erem Kaan BAŞOK
Serhat GÖÇER
Adnan BAŞARAN
Reşit TOKUÇ
Pages
250–255
DOI
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AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

Particular care should be taken when these instruments are used during laparoscopy, and further research is indicated to optimize the applications of these devices.

📌 3 Key Takeaways

🎯
Objective & Hypothesis:Objective: Energy based laparoscopic instruments can introduce undesirable injuries due to thermal spread to adjacent structures.
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Key Findings & Data:We assessed thermal spread during application of bipolar PlasmaKinetic™, LigaSure™ V and Harmonic ACE™ devices.
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Conclusion & Impact:Particular care should be taken when these instruments are used during laparoscopy, and further research is indicated to optimize the applications of these devices.
🔬Design:Research Article
📍Scope:Comprehensive Sample
⚙️Variables:Laparoskopi · Ultrasonik terapi · Değerlendirme çalışmaları

Abstract

Objective: Energy based laparoscopic instruments can introduce undesirable injuries due to thermal spread to adjacent structures. We assessed thermal spread during application of bipolar PlasmaKinetic™, LigaSure™ V and Harmonic ACE™ devices. Materials and methods: The extent of in vitro thermal spread of each device was measured by using infrared and electrode thermometer for superficial and deep temperatures, respectively. Measurement of temperatures was repeated 5 and 10 mm away from the application area of laparoscopic instruments at a minimum and maximum power level. Results: The mean increase of temperature for the duration of ultrasonic scalpel was significantly lower than bipolar energy modalities. PlasmaKinetic™ bipolar energy produced the highest mean temperatures in surrounding superficial tissues, and LigaSure™ V developed the highest mean temperature increase in surrounding deep tissues. Conclusion: Thermal spread was measured only in a limited the area of the surrounding tissues with all devices; however, ultrasonic scalpel may constitute safer option for energized dissection and hemostasis compared to bipolar energy. Particular care should be taken when these instruments are used during laparoscopy, and further research is indicated to optimize the applications of these devices.

Özet

Amaç: Enerji kullanan laparoskopik aletler komşu yapılarda termal yayılım ile oluşan istenmeyen doku hasarlarına yol açabilmektedir. Bu çalışmada bipolar PlasmaKinetic™, LigaSure™ V ve Harmonik ACE™ aletlerinin uygulanımı ile oluşan termal yayılım değerlendirildi. Gereç ve yöntem: Her bir aletin yüzeysel ve derin termal yayılım miktarı infrared ve elektrod termometre ile ölçüldü. Sıcaklık ölçümleri laparoskopik aletlerin uygulanım noktasından 5 mm ve 10 mm uzaklıkta minimum ve maksimum enerjilerde tekrar edildi. Bulgular: Ultrasonik makas uygulanımı sırasında oluşan ortalama sıcaklık artışı bipolar enerji modalitelerinden belirgin derecede daha düşüktü. PlasmaKinetic™ bipolar enerji uygulanımında çevre yüzeysel dokuda en yüksek ortalama sıcaklık artışı gözlenirken, LigaSure™ V bipolar enerjide çevre derin dokuda en yüksek sıcaklık artışı saptanmıştır. Sonuç: Çevre dokudaki termal yayılım tüm aletler için sınırlı bir alanda oluşmaktadır ve ultrasonik makas diseksiyon ve hemostazda bipolar enerjiye göre daha güvenli olabilir. Laparoskopide enerji aletlerinin uygulanımında dikkatli olunmalıdır ve bu konuda ileri araştırmalara gereksinim duyulmaktadır.

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Cite This Article

YILDIRIM, A., BAŞOK, E. K., GÖÇER, S., BAŞARAN, A., TOKUÇ, R. (2009). Evaluation of thermal spread during the application of laparoscopic bipolar and ultrasonic devices. Türk Üroloji Dergisi/Turkish Journal of Urology, Cilt: 35 - Sayı: 3, 250–255. https://ajindex.com/articles/328247

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