Lateral spread of heat during thyroidectomy  using different haemostatic devices

Adamczewski, Zbigniew; Król, Aleksander; Kałużna-Markowska, Karolina; Brzeziński, Jan; Lewiński, Andrzej; Dedecjus, Marek

doi:10.5604/12321966.1167721

Cited by 8 publications

(4 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Additionally, when the hernia sac is large, the peritoneum is originally thin and weak, causing more opportunity of injury. We also considered the possibility of thermal injury to the peritoneum since the active blade of the USAD is long (15-20 mm), and the effect of lateral thermal spread to the surrounding tissue is wide (2-5 mm) enough to injure the peritoneum in a narrow and limited space [17,18]. Our future direction is to initiate a new method to quantify the working space inside the preperitoneal space and to determine whether the hernia size and other factors affects the working space.…”

Section: Discussionmentioning

confidence: 99%

“…with an application time of 5 seconds, and reaches to a plateau around 80-100℃ when applied for a longer period of time. However, the mean temperature can easily elevate over 100℃ even with an application time of 5 seconds and over in maxium power settings (100%) [17,18]. Since protein coagulation and denaturation begins over 60℃ and collagen denaturation and cell membrane permeabilization begins over 80℃ [19], we believe that minimizing the application time (within 5 seconds) as suggested by Pogerlic et al [20], and minimizing the output power (60-70% power) should be useful to prevent maxium heating of the active blade.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Prevention and recovery for peritoneal injury during totally extraperitoneal inguinal hernia repair: A single-center retrospective cohort study

Nishiguchi¹,

Shoichi²,

Asaka³

et al. 2020

Preprint

View full text Add to dashboard Cite

Background During totally extraperitoneal (TEP) repair, peritoneal injury (PI) may result in technical difficulty due to the imparied working space inside the preperitoneal space. We aimed to clarify the factors causing PIs by focusing on the size of the hernia and to provide the prevention and recovery method for PI.Methods A total of 71 inguinal hernia with unilateral TEP repairs were classified by the size of hernia; Small group (<1cm, n=16) and Large group (≧1cm, n=55). Patient characteristics and surgical outcomes were analyzed retrospectively. TEP procedure was broke down into five phases (e.g. Phase 3 was a period from starting the dissection to transection of hernia sac) in the PI cases of the Large group (n=21). Common site of PI, maneuver and recovery method were further analyzed.Results Operative time (P<0.0001) and PI rate (P=0.015) were higher in the Large group. PI cases in the Large group showed a higher PI rate in Phase 3 (P=0.036) and PI mostly occurred by a sharp dissection of the medial side of hernia sac with using an ultrasonically activated device. In terms of recovery methods, pre-tied suture loop ligation and endoscopic suturing tended to be faster than doing nothing and conversion to TAPP but showed no significance (P=0.059).Conclusions Hernia size and a sharp dissection during the medial side of the hernia sac may be important factors causing PIs. A careful dissection combined with an appropriate blunt dissection is required for the prevention of PI because of the strong adhesion at the medial side and thin peritoneum in most cases of large hernia sacs. In cases of PI, extension of operative time could be prevented by ligation or suturing of the peritoneal defect.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Prevention and recovery for peritoneal injury during totally extraperitoneal inguinal hernia repair: A single-center retrospective cohort study

Nishiguchi¹,

Shoichi²,

Asaka³

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…The SonoSurg® instrument investigated in the present study has been previously investigated in a trial comparing different instruments in thyroid surgery. In that trial, the mean temperature of cutting blade was 81.5 C with the medium power setting and 99.2 C with the maximum power, and the highest temperature measured was 114.41 C [24]. The relatively low temperature with limited lateral spreading of heat causes less thermal injury to adjacent tissues compared to EC, which should reduce the number of skin flap complications [25,26].…”

Section: Ultrasonic Technologymentioning

confidence: 94%

Ultrasonic scissors decrease postoperative bleeding complications in mastectomy: A retrospective multicenter cohort study on 728 patients

Tamminen

Huttunen

Meretoja

et al. 2023

European Journal of Surgical Oncology

View full text Add to dashboard Cite

“…In recent years, alternatives to electrocoagulation have been developed and been widely used in thyroid surgery, such as bipolar vessel sealer and ultrasonic cutter, which provide rapid and effective hemostasis (2)(3)(4). However, a disadvantage of these systems is that they can damage adjacent anatomical structures by direct or lateral thermal spread (5)(6)(7). These adjacent structures include the external branch of the superior laryngeal nerve (EBSLN), and in particular, injury to the nerve occurs during the dissection of the upper pole of the thyroid gland (8,9).…”

Section: Introductionmentioning

confidence: 99%

The Effect of Different Hemostatic Systems on the Injury of the External Branch of the Superior Laryngeal Nerve in Thyroidectomy

Özben¹,

Özgültekin²,

Adatepe³

et al. 2019

Istanbul Med J

View full text Add to dashboard Cite

Amaç: Hızlı ve etkin bir şekilde hemostaz sağlayan damar mühürleyici ve ultrasonik koagülasyon sistemleri tiroid cerrahisinde yaygın bir şekilde kullanılmaktadır. Bu sistemlerin bir dezavantajı termal hasar yolu ile komşu anatomik yapılara zarar verebilmesidir. Ancak süperior laringeal sinirin eksternal dalının yaralanması ile ilgili veriler sınırlıdır. Bu çalışmanın amacı tiroidektomi ameliyatında kullanılan farklı damar kapama sistemlerinin bu sinir yaralanması üzerine olan etkisini değerlendirmektir. Yöntemler: Çalışmaya Ekim 2008 ile Şubat 2009 tarihleri arasında selim tiroid hastalığı nedeni ile tiroidektomi ameliyatı yapılan toplam 45 hasta dahil edildi. Hastalar randomize edilerek her biri 15'er hastadan oluşan toplam üç gruba ayrıldı. Ameliyatta ilk grupta damar mühürleyici, ikinci grupta harmonik kesici ve üçüncü grupta klasik sütür ile bağlama tekniği kullanıldı. Hastaların laringeal elektromiyografi bulguları ve ses şikayetleri karşılaştırıldı. Bulgular: Hastaların 37'si kadın (%82), 8'i erkek ve yaş ortalaması 47,9±11,1 yıl idi. Demografik özellikler ve cerrahi işlemler tüm gruplarda istatistiksel olarak benzer bulundu (p>0,05). Ameliyat öncesi elektromiyografi bulguları normal olan 84 adet sinirin kontrol incelemesinde damar mühürleyici grubunda 28 sinirin 3'ünde (%10,7), harmonik kesici grubunda 28 sinirin 2'sinde (%7,1) ve klasik sütür ile bağlama grubunda 28 sinirin 2'sinde (%7,1) tam veya parsiyel sinir yaralanması mevcuttu (p>0,05). Ses şikayetleri açısından gruplar arasında anlamlı fark saptanmadı (p>0,05). Sonuç: Damar kapama cihazlarının kullanımı klasik sütür bağlama tekniği ile karşılaştırıldığında, süperior laringeal sinirin eksternal dalı yaralanması riskini artırmadığı görülmektedir. Anahtar Kelimeler: Elektromiyografi, süperior laringeal sinirin eksternal dalı, sinir yaralanması, tiroidektomi, damar kapama sistemleri Introduction: Vessel-sealing and ultrasonic coagulation systems that provide rapid and effective hemostasis are widely used in thyroid surgery. An important disadvantage of these systems is injury to the neighboring anatomical structures by thermal damage. However, data on injury to the external branch of the superior laryngeal nerve is limited. The aim of this study was to evaluate the effect of different vascular closure systems on this nerve injury in thyroidectomy. Methods: A total of 45 patients who underwent thyroidectomy for benign thyroid disease between October 2008 and February 2009 were included in the study. Patients were randomized and divided into three groups, each consisting of 15 patients. Systems used were vessel-sealer in the first group, harmonic scalpel in the second group and conventional suture ligation technique in the third group. Laryngeal electromyography findings and voice complaints were compared. Results: There were 37 female (82%) and 8 male patients. The mean age was 47.9±11.1 years. Demographic features and surgical procedures were statistically similar in all groups (p>0.05). The control electromyography of 84 nerves with preoperatively con...

show abstract

Lateral spread of heat during thyroidectomy using different haemostatic devices

Cited by 8 publications

References 11 publications

Prevention and recovery for peritoneal injury during totally extraperitoneal inguinal hernia repair: A single-center retrospective cohort study

Prevention and recovery for peritoneal injury during totally extraperitoneal inguinal hernia repair: A single-center retrospective cohort study

Ultrasonic scissors decrease postoperative bleeding complications in mastectomy: A retrospective multicenter cohort study on 728 patients

The Effect of Different Hemostatic Systems on the Injury of the External Branch of the Superior Laryngeal Nerve in Thyroidectomy

Contact Info

Product

Resources

About