Easy Harvesting of Radial Artery With Ultrasonically Activated Scalpel

Posacıoğlu, Hakan; Atay, Yüksel; Çetindağ, Bülent; Sarıbülbül, Osman; Büket, Suat; Hamulu, Ahmet

doi:10.1016/s0003-4975(98)00059-9

Cited by 53 publications

(40 citation statements)

References 4 publications

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“…There are a few studies concerning the ultrasonically activated scalpel (UAS) in surgery. None of them has reported secondary hemorrhage problems [6,7,[15][16][17]. To our knowledge, there are no published studies available regarding the use of the UAS in tonsillectomy in terms of postoperative hemorrhage (PH).…”

Section: Introductionmentioning

confidence: 99%

Ultrasonically Activated Scalpel Compared with Electrocautery in Tonsillectomy

Schrey

Pulkkinen²,

Fremling³

et al. 2004

ORL

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The occurrence of postoperative bleeding, the quantity of operative bleeding and the duration of operation were retrospectively evaluated in 407 patients who underwent tonsillectomy within a 32-month period. They were operated on with either an ultrasonically activated scalpel (UAS), bipolar diathermy (BPD) or blunt dissection with monopolar diathermy (MPD) with the following results. (1) Primary bleeding was more common with MPD: MPD 7.1% vs. BPD 2.4% (p < 0.01) vs. UAS 1.0% (p < 0.001). Secondary bleeding was more common with UAS: UAS 19.6% vs. MPD 14.5% (p < 0.001) vs. BPD 14.5% (p < 0.01). There was no statistical significance in the differences between overall postoperative bleeding rates. (2) There was statistically significantly less operative bleeding with UAS:UAS 24.8 ml vs. MPD 58.7 ml vs. BPD 43.8 ml. (3) On the other hand, the operation time was on average longer with UAS: UAS 32.3 min vs. MPD 18.4 min vs. BPD 22.1 min. Our results suggest that UAS offers no significant advantage over MPD or BPD in tonsillectomy other than minimal operative bleeding possibly due to longer duration of operation.

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Section: Introductionmentioning

confidence: 99%

Ultrasonically Activated Scalpel Compared with Electrocautery in Tonsillectomy

Schrey

Pulkkinen²,

Fremling³

et al. 2004

ORL

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“…Regarding the problems associated with use close to a blood vessel, it has been reported on one hand that the ultrasonic scalpel least damages the vessel owing to a low temperature, whereas it has also been reported that the damage reaches the depth of vascular walls (6)(7)(8). These opposing opinions on influences on vascular walls are thought to result from deficient information on differing influences on vascular walls depending upon the method of an ultrasonic scalpel use in the vicinity of a blood vessel.…”

Section: Discussionmentioning

confidence: 99%

“…It has been reported on one hand that the ultrasonic scalpel least damages the vessel owing to a low temperature, whereas, on the other hand, it has also been reported that the damage reaches the depth of vascular walls (6)(7)(8)(9).…”

Section: Introductionmentioning

confidence: 99%

Comparison of ultrasonically activated scalpel and traditional technique in radial artery harvesting; an electron microscopic evaluation

Dumantepe

Kehlіbar²,

Güllü³

et al. 2011

Anadolu Kardiyol Derg

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ÖZETAmaç: Koroner arter baypas cerrahisinde radiyal arterin kondüit olarak kullanılması son yıllarda artan popülarite kazanmıştır. Bu prospektif randomize çalışmada; radiyal arter hazırlanması sırasında konvansiyonel elektrokoter ile ultrasonik koter kullanımının damar endoteline ve kan akımına etkilerini karşılaştırmayı, buna ek olarak hipotermi ve bekleme solüsyonlarının etkilerini göstermeyi hedefledik. Ultrasonik koter veya düşük voltajlı elektrokoter kullanımının endotel hasarına yol açıp açmadığının, elektron mikroskopu ile saptanması araştırmamızın bir diğer amacını oluşturdu. Yöntemler: Koroner arter hastalığı olan 182 hasta, 2008 ve 2009 yılları arasında, koroner revaskülarizasyon amaçlı ameliyat edildi. Radiyal arter 40 hastada kullanıldı ve bu hastalar ultrasonik koter (UK) (Grup 1; n=20) ve elektrokoter (EK) (Grup 2; n=20) grupları olarak iki gruba ayrıldı. Hastalar ayrıca greftin bekleme solüsyonuna görede iki alt gruba ayrıldı. Hazırlanan radiyal arterler oda sıcaklığında in situ ortamda (Grup 1) ve ABSTRACT Objective: Use of the radial artery (RA) as a conduit in coronary artery bypass grafting (CABG) has become increasingly popular in recent years. The aim of this prospective randomized study is to determine how the endothelial wall and blood flow of RA are differently affected with the usages of ultrasonic scalpel and conventional electrocautery in addition to effects of hypothermia and storage solutions. Histopathologic study was achieved by electron microscope to evaluate endothelium of the grafts. Methods: Between 2008 and 2009, 182 patients with coronary artery diseases were operated for coronary artery revascularization. The radial arteries were harvested for 40 of these patients and divided into two groups depending on the use of the ultrasonic cautery (UC) (n=20) and the high-frequency electrocautery (EC) (n=20). Patients were divided into two subgroups according to the storage media of the graft. RA was preserved in situ at room temperature (Group 1) and normothermic organ bath (NOB) (Group 2). Harvesting time, use of hemostatic clips, frequency of spasm, in situ free flow, temperature and endothelial damage were compared between the two groups. Statistical analysis was performed using one-way ANOVA, Friedman and unpaired t tests. Results: In all groups, blood flows were significantly decreased as parallel to the local temperatures. Second and third phase flows were similar in group EC 1 and UC 1 (p>0.05). Free flow was increased in group UC+NOB when comparing with only EC group (60.4±9.83 ml/min and 40.8±7.50 ml/min, p<0.001), whereas the graft preparing time "t2" was shorter in group EC than UC (10.9±2.42 min and 15.2±1.31 min, p<0.01). Nonetheless scoring of the groups in terms of endothelial cell structure and mitochondrial morphological changes did not show any significant difference. Conclusion: If endothelial integrity of the RA can be preserved along with the application of systemic temperature (NOB), regardless of harvesting technique, it provides better flow rates. (Anadolu Kar...

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“…Although the use of the harmonic scalpel may be associated with less risk of spasm [22], it is not compatible with the VasoView endoscopic system and was therefore not used in the open cases during this comparison.…”

Section: Postoperative Radial Artery Spasm and Patencymentioning

confidence: 99%