Current Technological Advances of Bipolar Coagulation

Vellimana, Ananth K.; Sciubba, Daniel M.; Noggle, Joseph C.; Jallo, George I.

doi:10.1227/01.neu.0000335644.57481.97

Cited by 16 publications

(12 citation statements)

References 38 publications

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“…Although the temperature should be high enough to ensure that coagulation is successful, ideally, it should also be low enough to prevent tissue adherence to the forceps and bumping. In practice, the optimal temperature may be approximately 809 C. 4) Several methods for controlling the temperature are available, including irrigation systems, 20) but the keys to this procedure are not only the equipment used but also the technique applied, as our results have demonstrated. Specifically, heat distribution in the tissue can be made more even by repeatedly opening and closing the forceps tips during coagulation.…”

Section: Discussionmentioning

confidence: 77%

“…Forceps made using heat pipe technology, such as the IsoCool TM forceps, feature a built-in cooling system. 20) based on heat-conducting pipes made of tiny copper spheres which are compressed into a wicking structure under vacuum. Using this type of forceps as opposed to ordinary gold-plated forceps, continuous coagulation can be applied for longer periods without bumping because the heat-pipe forceps maintain lower temperatures during coagulation.…”

Section: Discussionmentioning

confidence: 99%

“…7,12,19) Technological advances have led to significant improvements in bipolar forceps, enabling effective bleeding control and fine dissection. [1][2][3][4][5]10,11,[13][14][15][16][17][18]20) Nevertheless, the use of this type of forceps remains associated with certain problems such as adherence of charred tissues to the forceps; this problem sometimes leads to hemostasis failure and damage to the surrounding tissues. 2,13,14) In addition, continuous coagulation or coagulation under relatively high electrical output sometimes causes the coagulum to explode or rupture audibly.…”

Section: Introductionmentioning

confidence: 99%

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Bumping Phenomenon During Continuous Coagulation With Bipolar Forceps

Mikami

Wanibuchi

Mikuni

2012

Neurol. Med. Chir.(Tokyo)

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During continuous bipolar coagulation, the coagulum sometimes ruptures suddenly and audibly, leading to hemostasis failure and damage to the surrounding tissues. Such coagulum rupture is a phenomenon that is similar to microwave bumping, which occurs because of unequal heat distribution as a result of sudden elevation in temperature. The present study investigated the conditions under which bumping can occur during bipolar coagulation using samples of whole blood. Two types of bipolar forceps were assessed: forceps with gold-plated tips and IsoCool TM forceps. The time until the bumping phenomenon occurred was measured, and the occurrence rate of bumping was calculated. Thermal characteristics were then assayed using a thermographic camera. As the output of the bipolar coagulator increased, the time until bumping decreased whereas the occurrence rate of bumping during coagulation increased. At lower outputs, the occurrence rate of bumping was significantly lower using IsoCool TM forceps than that using forceps with gold-plated tips (p º 0.0001). Furthermore, bumping during coagulation could be prevented if the tips of the forceps at the coagulation site were repeatedly opened and closed. The bumping phenomenon is influenced by various factors such as heat, electrical power, equipment, and coagulation technique. Neurosurgeons should understand the technical certain aspects of these surgical tools and develop appropriate advanced techniques for temperature control.

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Section: Discussionmentioning

confidence: 77%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Bumping Phenomenon During Continuous Coagulation With Bipolar Forceps

Mikami

Wanibuchi

Mikuni

2012

Neurol. Med. Chir.(Tokyo)

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“…In this step, a precise activation/deactivation of the bipolar device is of utmost importance: this requires a good "eye-hand-foot coordination", or an accurate teamwork with the scrub nurse if she/he has the control of the bipolar foot pedal. Bipolar forceps with blunt tips (25 Malis units,5 Watts) may be used for straight medium caliber vessels (18)(19)(20).…”

Section: A Delicate Coagulation (20 Malis Units 3 Watts) Is Perfomentioning

confidence: 99%

Short-Burst Bipolar Coagulation for Repairing Partially Damaged Brain Arteries Preserving Their Flow: Technical Note

et al. 2016

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“…During the last century, many efforts have been made to develop surgical techniques and perioperative care programmes in order to improve recovery after surgery. In the 1920s, the idea of controlling blood loss by heat, used for many thousands of years, led to the development of electrosurgical instruments with the ability to control bleeding during surgical procedures (Vellimana, et al 2009). Today electrosurgery has evolved into modern bipolar technology, comprising various coagulation instruments, and has the potential to improve outcomes perioperatively.…”

Section: Introductionmentioning

confidence: 99%

On Quality Improvement in Gynaecological Cancer Surgery

Lundin

2020

Linköping University Medical Dissertations

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Objectives: The overall purpose of this thesis was to find medical and surgical treatment methods of improving the perioperative care of gynaecological cancer patients. The specific objectives were to determine whether a single dose tranexamic acid given immediately before surgery for presumed advanced ovarian cancer reduces perioperative blood loss and the need for blood transfusions, and to determine whether postoperative recovery, tissue damage, and inflammatory response markers differ between women operated with robotic and abdominal hysterectomy for low-risk endometrial cancer in an enhanced recovery after surgery (ERAS) programme, and to evaluate costs for hospital stay and postoperative recovery in relation to health impact. Material and Methods: The thesis was based on two randomised trials. The first trial was a randomised double-blind placebo-controlled multicentre study conducted in four hospitals in the southeast and central of Sweden between March 2008 and May 2012. One hundred women with presumed advanced ovarian cancer who had been scheduled for radical debulking surgery were included; 50 received tranexamic acid and 50 received a placebo. The main outcomes were blood loss and red blood cell transfusions. The second trial was a randomised open single centre trial at a Swedish university hospital, which included 50 women with low-risk endometrial cancer scheduled for radical surgery between February 2012 and May 2016; 25 women underwent robotic hysterectomy and 25 had abdominal hysterectomy. Anaesthesia and perioperative care followed an ERAS protocol in both groups. The EuroQol Group form EQ-5D-3L and the Short Form-36 evaluated the health-related quality of life. The Swedish Postoperative Symptoms Questionnaire assessed symptoms perioperatively until six weeks postoperatively. Venous blood samples were collected on several occasions until six weeks postoperatively and were analysed for markers reflecting inflammatory response and tissue damage. In addition, a health-economy analysis was conducted comparing total costs, quality-adjusted life years (QALYs) and cost per QALY between the surgical methods. Results: Total blood loss volume and transfusion rate following surgery in advanced ovarian cancer were significantly lower in the tranexamic group compared with the placebo group. Women with early endometrial cancer treated by robotic hysterectomy recovered significantly faster in the EQ-5D health index, and reached their preoperative level nearly two weeks earlier than the abdominal group. Differences regarding improvement in health-related quality of life (Short Form-36) comprising general health and social functioning were more favourable in the robotic hysterectomy group. Consumption of analgesics, pain intensity, postoperative symptom sum score and length of hospital stay were equal between the groups. The occurrence of complications was an independent risk factor and influenced most of the outcome measures adversely. Postoperative inflammatory response and tissue damage were lower after roboti...

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Current Technological Advances of Bipolar Coagulation

Cited by 16 publications

References 38 publications

Bumping Phenomenon During Continuous Coagulation With Bipolar Forceps

Bumping Phenomenon During Continuous Coagulation With Bipolar Forceps

Short-Burst Bipolar Coagulation for Repairing Partially Damaged Brain Arteries Preserving Their Flow: Technical Note

On Quality Improvement in Gynaecological Cancer Surgery

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