Division of Gastrointestinal Surgery, Nottingham University Hospitals, Queen's Medical Centre, Nottingham, UK.
Br J Surg. 2010 Mar;97(3):428-33. doi: 10.1002/bjs.6901.
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.
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.
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) degrees C respectively. Temperatures at the instrument tips after use for 15 s remained above 42 degrees 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) degrees C in tissues 1 cm away from the tip of the instrument.
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.
电外科解剖和止血应与最小的热扩散到周围组织相关。本研究调查了四种常用器械在离体应用后侧向热扩散的情况。
研究了单极和双极电刀（功率设置为 20、30 和 40 W）、Harmonic Scalpel 和 Ligasure（功率设置为 1、3 和 5）在 5、10 或 15 s 标准猪肌肉切割后的应用。记录器械尖端、尖端相邻组织和 1 cm 处产生的温度。
在最高功率设置下应用 5 s 后，单极和双极电刀、Harmonic Scalpel 和 Ligasure 器械尖端记录的最高平均（标准差）温度分别为 78.9(4.1)、41.9(2.2)、47.6(2.5)和 44.2(2.6)℃。使用 15 s 后，器械尖端的温度仍保持在 42℃以上，分别为 55、25、15 和 15 s。在 40 W 时应用 10 s 的单极电刀导致器械尖端 1 cm 远处的组织温度记录为 59.2(2.2)℃。
侧向热扩散程度随器械类型、功率设置和应用时间而变化。单极电刀产生的温度最高，在组织中的热扩散程度最大。
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