Microscopic, Macroscopic and Thermal Impact of Argon Plasma, Diode Laser, and Electrocoagulation on Ovarian Tissue

Abstract

Background/Aim: To compare the microscopic, macroscopic and thermal damage inflicted to ovarian tissue by conventional monopolar and bipolar energy, argon plasma coagulation (APC) and diode laser. Materials and Methods: Bovine ovaries were used as a substitute for human tissue and subjected to the four aforementioned techniques and the inflicted damage was measured. Sixty fresh and morphologically similar cadaveric bovine ovaries were divided into five equal groups, each group was subjected to one of the following energy applications for both 1 and 5 s: Monopolar, bipolar electrocoagulation, diode laser, preciseAPC ® and forcedAPC ® . Ovarian temperatures were measured at 4 and 8 s after treatment. Formalin-fixed ovarian specimens were examined by pathologists regarding macroscopic, microscopic and thermal tissue damage. Results: None of the ovaries reached the temperature producing severe damage (40˚C) after 1 s of energy transfer. Heating of adjacent ovarian tissue was least pronounced when preciseAPC ® and monopolar electrocoagulation were applied (27.2±3.3˚C and 28.2±2.9˚C after 5 s of application, respectively). Conversely, 41.7% of the ovaries subjected to bipolar electrocoagulation for 5 s overheated. ForcedAPC ® resulted in the most pronounced

Electrosurgery for the Gynaecologist: Cutting and Coagulating with One Instrument and One Setting

“…Limiting the coagulation depth means pinpoint coagulation, as short as possible, e.g. 1 sec [9] with a voltage as close as possible to 200 V, and using bipolar instruments with a small tip. The importance of short coagulation was illustrated by the damaged volume [10] and depth being 1.1 and 1.3 mm after a 2 or 4 sec of bipolar coagulation with a setting of coag force three and 30W without mentioning the tip size.…”

Effect and Safety of Diluted Vasopressin Injection for Bleeding Control During Robot-assisted Laparoscopic Myomectomy in Reproductive Women With Uterine Fibroids: A Randomized Controlled Pilot Trial (VALENTINE Trial)

“…Nevertheless, significant bleeding from damage to the myometrium and blood vessels is common during myomectomy regardless of the surgical method, which often results in blood transfusions or, in rare cases, conversion to open surgery to try to achieve rapid hemostasis (6)(7)(8). Therefore, efforts to reduce intraoperative bleeding from surgical damage by injecting vasopressin into the subserosa of the uterus have long been practiced.…”