Bipolar Cutting Method: Another Technique for Harvesting Donor Artery With Histological Investigation

Tokugawa, Joji; Ogura, Kyoko; Yatomi, Kenji; Kudo, Keiei; Hishii, Makoto; Tanikawa, Rokuya; Kamiyama, Hiroyasu

doi:10.1093/ons/opx086

Cited by 10 publications

(14 citation statements)

References 9 publications

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“…The monopolar system uses a computer-controlled low voltage level without electrical discharge, and therefore, heat is transferred to the deeper areas of the liver [12,13]. By contrast, the bipolar system can cauterize only active bleeding between the forceps without adjacent tissue damage [16,17]. Moreover, thermal damage to the deep cut surface of the liver can be avoided.…”

Section: Discussionmentioning

confidence: 99%

“…A saline-coupled bipolar forceps coagulation system is also considered to be a safe and reliable hemostatic device to decrease intraoperative hemorrhage [15]. It has also been widely used by neurosurgeons, as it can safely cauterize small blood vessels adjacent to a nerve without causing damage if the operator does not pinch the neural tissue [16,17]. By contrast, the coagulative effect of bipolar coagulation is weaker than that of monopolar coagulation and tends to prolong the transection time [18].…”

Section: Introductionmentioning

confidence: 99%

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Comparison of Operative Outcomes Between Monopolar and Bipolar Coagulation in Hepatectomy: A Propensity Score-Matched Analysis in a Single Center

Muraki

Morita

Ida

et al. 2022

Preprint

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Background: Various hemostatic devices have been utilized to reduce blood loss during hepatectomy. Nonetheless, a comparison between monopolar and bipolar coagulation, particularly their usefulness or inferiority, has been poorly documented. The aim of this study is to reveal the characteristics of these hemostatic devices.Methods: A total of 264 patients who underwent open hepatectomy at our institution from January 2009 to December 2018 were included. Monopolar and bipolar hemostatic devices were used in 160 (monopolar group) and 104 (bipolar group) cases, respectively. Operative outcomes and thermal damage to the resected specimens were compared between these groups using propensity score matching according to background factors. Multivariate logistic regression analysis was performed to identify predictive factors for postoperative complications.Results: After propensity score matching, 73 patients per group were enrolled. The monopolar group had significantly lower total operative time (239 vs. 275 min; P=0.013) and intraoperative blood loss (487 vs. 790 mL; P<0.001). However, the incidence rates of ascites (27.4% vs. 8.2%; P=0.002) and grade ≥3 intra-abdominal infection (12.3% vs. 2.7%; P=0.028) were significantly higher in the monopolar group. Thermal damage to the resected specimens was significantly longer in the monopolar group (4.6 vs. 1.2 mm; P<0.001). Use of monopolar hemostatic device was an independent risk factor for ascites (odds ratio, 5.626, 95% confidence interval 1.881–16.827; P=0.002) and severe intra-abdominal infection (odds ratio, 5.905, 95% confidence interval 1.096–31.825; P=0.039).Conclusions: Although monopolar devices have an excellent hemostatic ability, they might damage the remnant liver. The use of monopolar devices can be one of the factors that increase the frequency of complications.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Comparison of Operative Outcomes Between Monopolar and Bipolar Coagulation in Hepatectomy: A Propensity Score-Matched Analysis in a Single Center

Muraki

Morita

Ida

et al. 2022

Preprint

View full text Add to dashboard Cite

show abstract

“…The monopolar system uses a computer-controlled low voltage level without electrical discharge, and therefore, heat is transferred to the deeper areas of the liver [ 12 , 13 ]. By contrast, the bipolar system can cauterize only active bleeding between the forceps without adjacent tissue damage [ 16 , 17 ]. Moreover, thermal damage to the deep cut surface of the liver can be avoided.…”

Section: Discussionmentioning

confidence: 99%

“…A saline-coupled bipolar forceps coagulation system is also considered to be a safe and reliable hemostatic device to decrease intraoperative hemorrhage [ 15 ]. It has also been widely used by neurosurgeons, as it can safely cauterize small blood vessels adjacent to a nerve without causing damage if the operator does not pinch the neural tissue [ 16 , 17 ]. By contrast, the coagulative effect of bipolar coagulation is weaker than that of monopolar coagulation and tends to prolong the transection time [ 18 ].…”

Section: Introductionmentioning

confidence: 99%

Comparison of operative outcomes between monopolar and bipolar coagulation in hepatectomy: a propensity score-matched analysis in a single center

et al. 2022

View full text Add to dashboard Cite

Background Various hemostatic devices have been utilized to reduce blood loss during hepatectomy. Nonetheless, a comparison between monopolar and bipolar coagulation, particularly their usefulness or inferiority, has been poorly documented. The aim of this study is to reveal the characteristics of these hemostatic devices. Methods A total of 264 patients who underwent open hepatectomy at our institution from January 2009 to December 2018 were included. Monopolar and bipolar hemostatic devices were used in 160 (monopolar group) and 104 (bipolar group) cases, respectively. Operative outcomes and thermal damage to the resected specimens were compared between these groups using propensity score matching according to background factors. Multivariate logistic regression analysis was performed to identify predictive factors for postoperative complications. Results After propensity score matching, 73 patients per group were enrolled. The monopolar group had significantly lower total operative time (239 vs. 275 min; P = 0.013) and intraoperative blood loss (487 vs. 790 mL; P < 0.001). However, the incidence rates of ascites (27.4% vs. 8.2%; P = 0.002) and grade ≥ 3 intra-abdominal infection (12.3% vs. 2.7%; P = 0.028) were significantly higher in the monopolar group. Thermal damage to the resected specimens was significantly longer in the monopolar group (4.6 vs. 1.2 mm; P < 0.001). Use of monopolar hemostatic device was an independent risk factor for ascites (odds ratio, 5.626, 95% confidence interval 1.881–16.827; P = 0.002) and severe intra-abdominal infection (odds ratio, 5.905, 95% confidence interval 1.096–31.825; P = 0.039). Conclusions Although monopolar devices have an excellent hemostatic ability, they might damage the remnant liver. The use of monopolar devices can be one of the factors that increase the frequency of complications.

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“…[2] A bipolar cutting technique was not only used for harvesting donor arteries, such as the superficial temporal and occipital arteries, but also used for exposing the V3 during the far lateral approach. [25] In this study, we used the V3 exposure technique similar to the technique described by Balik and Takizawa and used the bipolar cutting method described by Tokugawa et al [25] to skeletonize the V3. We also described the anatomical relationship of the V3, the SOT, and the surrounding muscles.…”

Section: Operative Techniques For V3 Exposurementioning

confidence: 99%

Course of the V3 segment of the vertebral artery relative to the suboccipital triangle as an anatomical marker for a safe far lateral approach: A retrospective clinical study

Sriamornrattanakul

Akharathammachote

Chonhenchob

et al. 2022

Surgical Neurology International

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Background: The third segment of the vertebral artery (V3) is vulnerable during far lateral and retrosigmoid approaches. Although the suboccipital triangle (SOT) is a useful anatomical landmark, the relationship between V3 and the muscles forming the triangle is not well-described. We aimed to demonstrate the relationship between the V3, surrounding muscles, and SOT in clinical cases. Methods: Operative videos of patients with the vertebral artery (VA) and posterior inferior cerebellar artery (PICA) aneurysms treated with occipital artery-PICA bypass through the far lateral approach were examined. Videos from January 2015 to October 2021 were retrospectively reviewed to determine anatomy of the V3 and the SOT. Results: Fourteen patients were included in this study. The ipsilateral V3 was identified without injury in all patients using the bipolar cutting technique. The lateral 68.2% of the horizontal V3 segment, including the V3 bulge, was covered by the inferomedial part of the superior oblique muscle (SO). The medial 23.9% was covered by the inferolateral part of the rectus capitis posterior major muscle. The inferomedial part of the horizontal V3 segment is located within the SOT. Conclusion: Most of the V3, including the V3 bulge, were located beneath the SO and the inferomedial part of V3 located within the SOT. Elevation of the SO should be performed carefully using the bipolar cutting technique to avoid injury to the V3. To the best of our knowledge, this is the first description of the V3 relative to the SOT in the clinical setting.

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Bipolar Cutting Method: Another Technique for Harvesting Donor Artery With Histological Investigation

Abstract: The bipolar cutting method is a useful and safe method for harvesting donor scalp artery.

Cited by 10 publications

References 9 publications

Comparison of Operative Outcomes Between Monopolar and Bipolar Coagulation in Hepatectomy: A Propensity Score-Matched Analysis in a Single Center

Comparison of Operative Outcomes Between Monopolar and Bipolar Coagulation in Hepatectomy: A Propensity Score-Matched Analysis in a Single Center

Comparison of operative outcomes between monopolar and bipolar coagulation in hepatectomy: a propensity score-matched analysis in a single center

Course of the V3 segment of the vertebral artery relative to the suboccipital triangle as an anatomical marker for a safe far lateral approach: A retrospective clinical study

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