Document Detail


Residual heat of laparoscopic energy devices: how long must the surgeon wait to touch additional tissue?
MedLine Citation:
PMID:  21594739     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Energy devices are essential laparoscopic tools. Residual heat is defined as the increased instrument temperature after energy activation is completed. This study aimed to determine the length of time a surgeon needs to wait before touching other tissue using four common laparoscopic energy sources.
METHODS: Thermal imaging quantified instrument and tissue temperature ex vivo using monopolar coagulation, argon beam coagulation, ultrasonic dissection, and bipolar tissue fusion devices. To simulate realistic operative usage, each instrument was activated for 5 s four consecutive times with 5 s pauses between fires. Thermal conductivity to bovine liver tissue was measured 2.5, 5, 10, and 20 s after final activation.
RESULTS: The maximum increase in instrument tip temperature was 172 ± 63°C for the ultrasonic dissection, 81 ± 18°C for the monopolar coagulation, 46 ± 19°C for the bipolar tissue fusion, and 1 ± 1°C for the argon beam coagulation (P < 0.05 for all comparisons). Touching the instrument tip to tissue at four intervals after the final activation (2.5, 5, 10, and 20 s) found that ultrasonic energy raised the tissue temperature higher (maximum change, 58°C) than the other three energy devices at all four time points (P < 0.05).
CONCLUSIONS: Ultrasonic energy instruments have greater residual heat than monopolar electrosurgery, bipolar tissue fusion, and argon beam. The ultrasonic energy instrument tips heated tissue more than 20°C from baseline even 20 s after activation; whereas all the other energy sources raised the tissue temperature less than 20°C by 5 s. These practical findings may alter a surgeon's usage of these common energy devices.
Authors:
Henry R Govekar; Thomas N Robinson; Greg V Stiegmann; Francis T McGreevy
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Publication Detail:
Type:  In Vitro; Journal Article     Date:  2011-05-19
Journal Detail:
Title:  Surgical endoscopy     Volume:  25     ISSN:  1432-2218     ISO Abbreviation:  Surg Endosc     Publication Date:  2011 Nov 
Date Detail:
Created Date:  2011-10-14     Completed Date:  2012-02-13     Revised Date:  2012-05-17    
Medline Journal Info:
Nlm Unique ID:  8806653     Medline TA:  Surg Endosc     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  3499-502     Citation Subset:  IM    
Affiliation:
Department of Surgery, University of Colorado Denver School of Medicine, 12631 East 17th Ave., MS C313, Aurora, CO 80045, USA.
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MeSH Terms
Descriptor/Qualifier:
Animals
Cattle
Electrosurgery / instrumentation
Hot Temperature*
Laparoscopy / instrumentation*
Liver / surgery*
Thermography
Ultrasonic Surgical Procedures / instrumentation
Comments/Corrections
Comment In:
J Urol. 2012 May;187(5):1714-5   [PMID:  22494726 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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