This is the Scientific Surgery Archive, which contains all randomized clinical trials in surgery that have been identified by searching the top 50 English language medical journal issues since January 1998. Compiled by Jonothan J. Earnshaw, former Editor-in-Chief, BJS
Comparison of lateral thermal spread using monopolar and bipolar diathermy, the Harmonic Scalpel™ and the Ligasure™. BJS 2010; 97: 428-433.
Published: 25th January 2010
Authors: P. A. Sutton, S. Awad, A. C. Perkins, D. N. Lobo
Background
Electrosurgery for dissection and haemostasis should be associated with minimal thermal spread to surrounding tissues. This study investigated lateral thermal spread following ex vivo application of four commonly utilized instruments.
Method
Monopolar and bipolar diathermy (power settings 20, 30 and 40 W), the Harmonic Scalpel™ and Ligasure™ (power settings 1, 3 and 5) were studied after application to standardized porcine muscle cuts for 5, 10 or 15 s. Temperatures generated at the tips of the instruments, in the tissues adjacent to the tips and 1 cm away were recorded.
Results
Following a 5‐s application at the highest power setting, the highest mean(s.d.) temperatures recorded at the tips of monopolar and bipolar diathermy, Harmonic Scalpel™ and Ligasure™ instruments were 78·9(4·1), 41·9(2·2), 47·6(2·5) and 44·2(2·6) °C respectively. Temperatures at the instrument tips after use for 15 s remained above 42 °C for 55, 25, 15 and 15 s respectively. Applying monopolar diathermy (10 s at 40 W) resulted in a temperature recording of 59·2(2·2) °C in tissues 1 cm away from the tip of the instrument.
Conclusion
The degree of lateral thermal spread varied with instrument type, power setting and application time. Monopolar diathermy resulted in the highest temperatures and the greatest degree of thermal spread in tissues. Copyright © 2010 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.
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