Department of Medicine I, University Hospital Dresden, Technische Universität Dresden (TU Dresden), Dresden, Germany.
Chair of Microsystems, Faculty of Electrical and Computer Engineering, Technische Universität Dresden (TU Dresden), Dresden, Germany.
Surg Endosc. 2022 Jun;36(6):4507-4517. doi: 10.1007/s00464-021-08804-4. Epub 2021 Oct 27.
Endoscopic and laparoscopic electrosurgical devices (ED) are of great importance in modern medicine but can cause adverse events such as tissue injuries and burns from residual heat. While laparoscopic tools are well investigated, detailed insights about the temperature profile of endoscopic knives are lacking. Our aim is to investigate the temperature and the residual heat of laparoscopic and endoscopic monopolar instruments to increase the safety in handling ED.
An infrared camera was used to measure the temperature of laparoscopic and endoscopic instruments during energy application and to determine the cooling time to below 50 °C at a porcine stomach. Different power levels and cutting intervals were studied to investigate their impact on the temperature profile.
During activation, the laparoscopic hook exceeded 120 °C regularly for an up to 10 mm shaft length. With regards to endoknives, only the Dual Tip Knife showed a shaft temperature of above 50 °C. The residual heat of the laparoscopic hook remained above 50 °C for at least 15 s after activation. Endoknives cooled to below 50 °C in 4 s. A higher power level and longer cutting duration significantly increased the shaft temperature and prolonged the cooling time (p < 0.001).
Residual heat and maximum temperature during energy application depend strongly on the chosen effect and cutting duration. To avoid potential injuries, the user should not touch any tissue with the laparoscopic hook for at least 15 s and with the endoknives for at least 4 s after energy application. As the shaft also heats up to over 120 °C, the user should be careful to avoid tissue contact during activation with the shaft. These results should be strongly considered for safety reasons when handling monopolar ED.
内镜和腹腔镜电外科设备（ED）在现代医学中非常重要，但会导致组织损伤和余热灼伤等不良事件。虽然腹腔镜工具已经得到了很好的研究，但对内镜刀的温度分布缺乏详细的了解。我们的目的是研究腹腔镜和内镜单极器械的温度和余热，以提高 ED 处理的安全性。
使用红外摄像机测量能量应用过程中腹腔镜和内镜器械的温度，并确定在猪胃上冷却至 50°C 以下的时间。研究了不同的功率水平和切割间隔，以研究它们对温度分布的影响。
在激活过程中，腹腔镜钩的温度经常超过 120°C，最长可达 10mm 的轴长。对于内镜刀，只有 Dual Tip Knife 的轴温超过 50°C。腹腔镜钩在激活后至少 15 秒内保持在 50°C 以上的余热。内镜刀在 4 秒内冷却至 50°C 以下。更高的功率水平和更长的切割持续时间显著增加了轴温并延长了冷却时间（p<0.001）。
能量应用过程中的余热和最高温度强烈取决于所选的效果和切割持续时间。为了避免潜在的损伤，使用者在激活后至少 15 秒内不应接触任何组织，在能量应用后至少 4 秒内不应接触内镜刀的轴。由于轴也会加热到 120°C 以上，使用者在激活时应小心避免与组织接触。出于安全考虑，这些结果在处理单极 ED 时应予以充分考虑。
