The Shaw haemostatic scalpel in paediatric surgery: clinical report on 3000 operations.

This report presents the experience in a prospective series of 100 operative procedures in all fields of paediatric surgery with the Shaw haemostatic scalpel, which we have subsequently used in more than 3000 further operations. The Shaw scalpel proved to be advantageous in about 80% of major cases. The scalpel cuts tissue with a sharp steel edge, like a cold scalpel, and simultaneously seals blood vessels by heat thermally conducted to the tissue from heated blade which is electrically insulated from the patient. The heat seals most small blood vessels (under 2 mm) as they are cut. Since no electric current passes through the patient, a grounding pad is not needed and the risk of accidental electrical current burns at grounding sites is eliminated. Muscle stimulation associated with the use of a normal cautery is avoided, improving surgical precision of cutting. The Shaw haemostatic scalpel minimizes damage to the tissue as compared with other thermocoagulating instruments. Since it seals small vessels as it cuts tissue, it largely eliminates the flow of blood into the incised area and allows better visibility of the surgical field. The use of the scalpel requires a different cutting technique which is however easy to learn. The Shaw haemostatic scalpel reduces blood loss and overall operating time in major cases. It is relatively inexpensive and can be recommended for use in paediatric surgery.