Comparative Assessment of Thermal Damage Induced by Bipolar Forceps in a Bovine Liver.

IF 1.7 4区医学 Q3 CLINICAL NEUROLOGY

Operative Neurosurgery Pub Date : 2025-06-01 Epub Date: 2024-10-29 DOI:10.1227/ons.0000000000001385

Neslihan Çavuşoğlu, Abuzer Güngör, Muhammed Emin Aksu, Erhan Emel, Berk Burak Berker, Yücel Doğruel, Uğur Türe

{"title":"Comparative Assessment of Thermal Damage Induced by Bipolar Forceps in a Bovine Liver.","authors":"Neslihan Çavuşoğlu, Abuzer Güngör, Muhammed Emin Aksu, Erhan Emel, Berk Burak Berker, Yücel Doğruel, Uğur Türe","doi":"10.1227/ons.0000000000001385","DOIUrl":null,"url":null,"abstract":"Background and objectives: Bipolar electrocautery systems in neurosurgical procedures may induce thermal damage to adjacent tissues, especially neural tissues. Therefore, it is crucial to control thermal spread from the tips of bipolar forceps into adjacent tissues. The goal of this study was to compare the thermal damage induced in unintended adjacent tissues during coagulation with 6 different bipolar forceps.Methods: Fresh ex vivo bovine liver tissues were coagulated with 6 different bipolar forceps: Aesculap® nonstick, Atlas Choice™, ISOCOOL®, SilverGlide®, Spetzler™-Malis®, and VersaTru® (45 trials per bipolar forceps). For all forceps, coagulation was performed with a power setting of 35 Malis units, 1-mm tip spacing, and 3-second activation time. Tissue samples were evaluated for the extent of thermal damage (30 trials per bipolar forceps). Tissue temperatures were measured with thermocouples placed in the tissues (15 trials per bipolar forceps). The area and maximum depth of thermal damage were measured manually with image analysis software.Results: The injury area induced by ISOCOOL® and Atlas Choice™ bipolar forceps was significantly less than that of the Aesculap® nonstick ( P < .001), SilverGlide® ( P < .001), Spetzler™-Malis® ( P < .001), and VersaTru® ( P < .001). The areas of thermal injury caused by the ISOCOOL® and Atlas Choice™ forceps were not statistically significantly different from each other ( P = .08). Lesions from the ISOCOOL® and Atlas Choice™ forceps showed significantly less depth of injury than the Aesculap® nonstick ( P = .001), SilverGlide® ( P < .001), Spetzler™-Malis® ( P < .001), and VersaTru® ( P < .001). There was no statistically significant difference in the depth of thermal injury between the ISOCOOL® and Atlas Choice™ forceps ( P = 1.0).Conclusion: Bipolar forceps that effectively limit excessive thermal dissipation reduce the risk of unintended injury to adjacent or peripheral tissues. In an ex vivo bovine liver model, coagulation tests with ISOCOOL® and Atlas Choice™ bipolar forceps resulted in less depth and lower mean injury areas compared with other forceps.","PeriodicalId":54254,"journal":{"name":"Operative Neurosurgery","volume":" ","pages":"832-840"},"PeriodicalIF":1.7000,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Operative Neurosurgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1227/ons.0000000000001385","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/10/29 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Background and objectives: Bipolar electrocautery systems in neurosurgical procedures may induce thermal damage to adjacent tissues, especially neural tissues. Therefore, it is crucial to control thermal spread from the tips of bipolar forceps into adjacent tissues. The goal of this study was to compare the thermal damage induced in unintended adjacent tissues during coagulation with 6 different bipolar forceps.

Methods: Fresh ex vivo bovine liver tissues were coagulated with 6 different bipolar forceps: Aesculap® nonstick, Atlas Choice™, ISOCOOL®, SilverGlide®, Spetzler™-Malis®, and VersaTru® (45 trials per bipolar forceps). For all forceps, coagulation was performed with a power setting of 35 Malis units, 1-mm tip spacing, and 3-second activation time. Tissue samples were evaluated for the extent of thermal damage (30 trials per bipolar forceps). Tissue temperatures were measured with thermocouples placed in the tissues (15 trials per bipolar forceps). The area and maximum depth of thermal damage were measured manually with image analysis software.

Results: The injury area induced by ISOCOOL® and Atlas Choice™ bipolar forceps was significantly less than that of the Aesculap® nonstick ( P < .001), SilverGlide® ( P < .001), Spetzler™-Malis® ( P < .001), and VersaTru® ( P < .001). The areas of thermal injury caused by the ISOCOOL® and Atlas Choice™ forceps were not statistically significantly different from each other ( P = .08). Lesions from the ISOCOOL® and Atlas Choice™ forceps showed significantly less depth of injury than the Aesculap® nonstick ( P = .001), SilverGlide® ( P < .001), Spetzler™-Malis® ( P < .001), and VersaTru® ( P < .001). There was no statistically significant difference in the depth of thermal injury between the ISOCOOL® and Atlas Choice™ forceps ( P = 1.0).

Conclusion: Bipolar forceps that effectively limit excessive thermal dissipation reduce the risk of unintended injury to adjacent or peripheral tissues. In an ex vivo bovine liver model, coagulation tests with ISOCOOL® and Atlas Choice™ bipolar forceps resulted in less depth and lower mean injury areas compared with other forceps.

查看原文本刊更多论文

双极镊子对牛肝脏热损伤的比较评估

背景和目的：神经外科手术中的双极电烧系统可能会对邻近组织，尤其是神经组织造成热损伤。因此，控制双极电烧钳尖端向邻近组织的热扩散至关重要。本研究的目的是比较 6 种不同的双极钳在凝固过程中对意外邻近组织造成的热损伤：方法：使用 6 种不同的双极钳凝固新鲜的体外牛肝组织：Aesculap® nonstick、Atlas Choice™、ISOCOOL®、SilverGlide®、Spetzler™-Malis® 和 VersaTru®（每种双极钳试验 45 次）。对于所有镊子，凝固都是在功率设置为 35 Malis 单位、针尖间距为 1 毫米、激活时间为 3 秒的条件下进行的。对组织样本的热损伤程度进行评估（每把双极钳进行 30 次试验）。通过放置在组织中的热电偶测量组织温度（每把双极镊子 15 次试验）。用图像分析软件手动测量热损伤的面积和最大深度：结果：ISOCOOL® 和 Atlas Choice™ 双极钳造成的损伤面积明显小于 Aesculap® nonstick（P < .001）、SilverGlide®（P < .001）、Spetzler™-Malis®（P < .001）和 VersaTru®（P < .001）。ISOCOOL® 和 Atlas Choice™ 钳造成的热损伤区域在统计学上没有显著差异 (P = .08)。ISOCOOL® 和 Atlas Choice™ 电钳造成的损伤深度明显低于 Aesculap® 不粘锅（P = .001）、SilverGlide®（P < .001）、Spetzler™-Malis®（P < .001）和 VersaTru®（P < .001）。ISOCOOL® 和 Atlas Choice™ 钳的热损伤深度在统计学上没有明显差异（P = 1.0）：结论：有效限制过度热耗散的双极镊子可降低对邻近或外周组织造成意外伤害的风险。在体外牛肝脏模型中，使用 ISOCOOL® 和 Atlas Choice™ 双极镊子进行凝血测试，与其他镊子相比，损伤深度更小，平均损伤面积更低。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Operative Neurosurgery Medicine-Neurology (clinical)

CiteScore

3.10

自引率

13.00%

发文量

530

期刊介绍： Operative Neurosurgery is a bi-monthly, unique publication focusing exclusively on surgical technique and devices, providing practical, skill-enhancing guidance to its readers. Complementing the clinical and research studies published in Neurosurgery, Operative Neurosurgery brings the reader technical material that highlights operative procedures, anatomy, instrumentation, devices, and technology. Operative Neurosurgery is the practical resource for cutting-edge material that brings the surgeon the most up to date literature on operative practice and technique