Tucker R D, Platz C E, Sievert C E, Vennes J A, Silvis S E
Department of Pathology, University of Iowa Hospitals & Clinics, Iowa City.
Am J Gastroenterol. 1990 Oct;85(10):1386-90.
The energy required and tissue damage in bipolar and monopolar polypectomy snares were compared in a canine model. The bipolar snare required an average of 34 joules of energy, whereas the monopolar snare required 228 joules to cut the same diameter of gastric mucosa tended into a polypoid structure (p = 0.0005). The reduced energy delivered to the tissue from the bipolar procedure resulted in only 32% average depth of damage to the underlying gastric wall, whereas the monopolar procedure caused an average 69% (p = 0.001). Surgically created polyps required 247 joules and 69 joules for corresponding monopolar and bipolar polypectomy (p = 0.001). The decreased energy required and the correspondingly reduced damage caused to the underlying bowel wall by the bipolar snare should reduce the incidence of perforation and post-polypectomy syndrome. The bipolar snare completes a local circuit about the snare, eliminating the return electrode and, consequently, the possibility of any return electrode burns. The bipolar snare thus provides an added safety margin during polypectomy.
在犬类模型中比较了双极和单极息肉切除圈套器所需的能量及组织损伤情况。双极圈套器平均需要34焦耳的能量，而单极圈套器切割相同直径的呈息肉样结构的胃黏膜需要228焦耳的能量（p = 0.0005）。双极操作传递到组织的能量减少，导致对胃壁深层的平均损伤深度仅为32%，而单极操作造成的平均损伤深度为69%（p = 0.001）。手术制造的息肉，单极和双极息肉切除分别需要247焦耳和69焦耳的能量（p = 0.001）。双极圈套器所需能量的减少以及对肠壁深层相应减少的损伤，应会降低穿孔和息肉切除术后综合征的发生率。双极圈套器在圈套器周围形成局部回路，无需回路电极，因此也就消除了回路电极灼伤的可能性。双极圈套器因此在息肉切除过程中提供了额外的安全保障。
