Lateral thermal damage of mesoappendix and appendiceal base during laparoscopic appendectomy in children: comparison of the harmonic scalpel (Ultracision), bipolar coagulation (LigaSure), and thermal fusion technology (MiSeal)

Pogorelić, Zenon; Katić, Josip; Mrklić, Ivana; Jerončić, Ana; Šušnjar, Tomislav; Jukić, Miro; Vilović, Katarina; Perko, Zdravko

doi:10.1016/j.jss.2017.01.014

Cited by 45 publications

(29 citation statements)

References 22 publications

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“…The dynamics of thermal spread may be influenced by the difference in blood supply to healthy and inflamed tissues or their hydrophilicity. However, Pogorelić reported no significant differences in lateral thermal spread during appendectomy in patients with acute appendicitis and in the absence of inflammation [13]. In patients with appendicitis, the diameter of the inflamed appendix changes along its course, which means that its regions can heat up to different temperatures as the current passes through it.…”

Section: Discussionmentioning

confidence: 99%

“…This could be explained by the design of our experiment: appendectomy was performed on the non-inflamed appendix. A study of lateral thermal damage to the mesoappendix and the appendiceal base during laparoscopic appendectomy in children demonstrated that the postoperative pain syndrome and the duration of hospital stay directly depend on the temperature of the heated tissue and the size of the thermal lesion [13].…”

Section: Discussionmentioning

confidence: 99%

“…As lateral thermal damage is more pronounced in patients with an inflamed appendix [13,14], and drawing on the literature [11], we hypothesized that lateral thermal spread would be greater with higher power settings and that the heating of nearby tissue, including the cecum and the mesoappendix, could lead to complications. The aim of this study was to investigate the lateral thermal spread during monopolar-aided appendectomy at different ESU power settings using realtime infrared thermography and to evaluate the severity of thermal injury to the affected tissue.…”

Section: Introductionmentioning

confidence: 99%

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Thermal effects of monopolar electrosurgery detected by real-time infrared thermography: an experimental appendectomy study

Nechay¹,

Titkova²,

Anurov³

et al. 2020

Preprint

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Purposes. Monopolar energy (ME) is routinely used in appendectomy. This study aimed to investigate the degree of lateral thermal spread generated by ME and to evaluate the thermal injury sustained by the close-lying tissues. Materials and methods. Appendectomy with a monopolar Maryland dissector was performed in 8 rabbits (at 30 and 60 W power settings). A high-resolution infrared camera was used to record tissue heating during the intervention. After autopsy macroscopic changes were evaluated and tissue samples were subjected to myeloperoxidase (MPO) assay and histological examination. Results. No significant differences in the extent of thermal spread, MPO activity and histological signs of inflammation were observed between groups. Regardless of the power settings, the heat spread exceeded 2 cm laterally along the mesoappendix when application time exceeded 3 s. The spread of heat through tubular structures in both groups caused a significant temperature rise in the nearby intestinal loop, resulting in perforation (n=3) and necrosis (n=1). Conclusions. Application time is critical in thermal spread during appendectomy aided by ME. Tubular anatomic structures can enhance thermal injury on distant tissues. The observed effects of ME bear clinical relevance that need further investigation.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Thermal effects of monopolar electrosurgery detected by real-time infrared thermography: an experimental appendectomy study

Nechay¹,

Titkova²,

Anurov³

et al. 2020

Preprint

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“…These devices contribute to shortening the operation time and suppressing the amount of bleeding [5,6]. However, it is reported that thermal damage caused by surgical device occurs not only at the target site but also in the surrounding tissue [7,8,9,10]. Because thermal damage (coagulation) to neighboring organs may cause postoperative pain and serious complications [11,12,13], it is necessary to evaluate the heating characteristic of tissues surrounding the device.…”

Section: Introductionmentioning

confidence: 99%

Coagulated region analysis in a microwave surgical device with temperature-dependent physical properties of tissue

Manago

Saito

2019

IEICE Electron. Express

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In surgical devices, it is pointed out that tissues around these devices may experience thermal damage (coagulation). Therefore, evaluating the coagulated region generated by a microwave surgical device is an important issue. In this paper, we estimate the distribution of the coagulated region using numerical calculation. Then, there is a possibility that the calculated results will be affected by change to the electrical and thermal constants during heating. Therefore, the temperature dependence of the tissue was considered. As a result, it was confirmed that the coagulation width at the center of the lower blade was 0.5 mm larger than that without temperature dependence.

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“…Complicated intra-abdominal infections in the paediatric population are generally caused by appendiceal perforations and are considered to be one of the most important causes of morbidity in children [2]. Laparoscopic appendectomy is a safe and effective procedure for the treatment of AA in children [3][4]. Many studies have shown that the incidence of AA is higher in the summer [5][6][7]; however, the reason for this phenomenon remains unclear.…”

Section: Introductionmentioning

confidence: 99%

Seasonal variations in the occurrence of acute appendicitis and their relationship with the presence of fecaliths in children

Hsu

Chin

2019

Preprint

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Background Acute appendicitis (AA) is the most common surgical condition in children. Although a higher incidence of AA in summer has been reported, the reason for this observation remains unclear. The purpose of this study was to compare the clinical findings of AA patients who underwent appendectomies during the summer months with those who underwent the procedure during the non-summer months. Methods The clinical data of 171 patients who underwent appendectomy from January 2013 to December 2016 were reviewed. The patients were divided into a summer group (from May to October) and a non-summer group (from November to April) based on the month when appendectomy was performed. All patients were under 18 years of age at the time of surgery. The medical records including laboratory data, computed tomography scans, pathology reports and operative notes were reviewed. Results The number of patients with AA was higher in the summer group than in the non-summer group (101 vs. 70 patients). No significant differences in the laboratory results between the two groups of patients were observed. The percentage of AA patients who presented with a fecalith was significantly lower in the summer group (33.6%) than in the non-summer group (55.7%). No significant differences in the incidence of appendiceal perforations and abscesses, as well as postoperative complications were observed between the two groups. Conclusions The percentage of AA patients with fecaliths in summer was lower than that in the non-summer months. The increase in the number of AA patients in summer may be due to the increased occurrence of lymphoid hyperplasia, which may be correlated with the yearly outbreak of enterovirus infection during this period.

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Lateral thermal damage of mesoappendix and appendiceal base during laparoscopic appendectomy in children: comparison of the harmonic scalpel (Ultracision), bipolar coagulation (LigaSure), and thermal fusion technology (MiSeal)

Cited by 45 publications

References 22 publications

Thermal effects of monopolar electrosurgery detected by real-time infrared thermography: an experimental appendectomy study

Thermal effects of monopolar electrosurgery detected by real-time infrared thermography: an experimental appendectomy study

Coagulated region analysis in a microwave surgical device with temperature-dependent physical properties of tissue

Seasonal variations in the occurrence of acute appendicitis and their relationship with the presence of fecaliths in children

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