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J Invest Surg ; 33(1): 59-66, 2020 Jan.
Article in English | MEDLINE | ID: covidwho-1455005


Background: Bipolar sealing devices are routinely used to seal blood vessels. The aim of the study is to evaluate the feasibility and safety of colonic sealing with the use of the bipolar energy devices in rats as model for experimental appendectomy. Methods: Seventy-five male Wistar rats underwent a cecal resection with four different bipolar sealing devices or a linear stapler. The harvesting procedure was performed immediately or at postoperative day (POD) 7. The sealing front bursting pressure (BP) was measured in both groups. At POD7, the resection line was clinically examined and the hydroxyproline (HDP) levels were determined. Hematoxylin and Eosin (H&E) staining was used for histopathological evaluation of the sealing front as well. Results: There was no mortality and no insufficiency. The BPs between the bipolar sealing devices showed no statistical differences. The early phase of the seal (POD 0) provides a low BP with an 30.8% increase until POD 7. The BPs in the stapler group showed significant better values. The hydroxyproline levels did not differ statistically between the groups. Histopathologically, there were more signs of ischemic necrosis in the stapler group than in the sealing devices groups. Conclusion: The resection and sealing of the cecum as an experimental appendectomy model with the use of bipolar energy devices proved feasible and safe in rats. The different energy devices in this study produce comparable results. To justify clinical practice in humans, several studies on the underlying mechanisms of early stage wound healing are needed.

Appendectomy/instrumentation , Cecum/surgery , Electrocoagulation/instrumentation , Hemostasis, Surgical/instrumentation , Wound Closure Techniques/instrumentation , Animals , Appendectomy/adverse effects , Appendectomy/methods , Electrocoagulation/methods , Feasibility Studies , Hemostasis, Surgical/adverse effects , Hemostasis, Surgical/methods , Male , Models, Animal , Rats , Rats, Wistar , Surgical Staplers/adverse effects , Wound Closure Techniques/adverse effects
J Laryngol Otol ; 135(10): 848-854, 2021 Oct.
Article in English | MEDLINE | ID: covidwho-1454702


OBJECTIVE: The Harmonic Scalpel and Ligasure (Covidien) devices are commonly used in head and neck surgery. Parotidectomy is a complex and intricate surgery that requires careful dissection of the facial nerve. This study aimed to compare surgical outcomes in parotidectomy using these haemostatic devices with traditional scalpel and cautery. METHOD: A systematic review of the literature was performed with subsequent meta-analysis of seven studies that compared the use of haemostatic devices to traditional scalpel and cautery in parotidectomy. Outcome measures included: temporary facial paresis, operating time, intra-operative blood loss, post-operative drain output and length of hospital stay. RESULTS: A total of 7 studies representing 675 patients were identified: 372 patients were treated with haemostatic devices, and 303 patients were treated with scalpel and cautery. Statistically significant outcomes favouring the use of haemostatic devices included operating time, intra-operative blood loss and post-operative drain output. Outcome measures that did not favour either treatment included facial nerve paresis and length of hospital stay. CONCLUSION: Overall, haemostatic devices were found to reduce operating time, intra-operative blood loss and post-operative drain output.

Dissection/adverse effects , Facial Nerve/surgery , Hemostasis, Surgical/instrumentation , Parotid Gland/surgery , Blood Loss, Surgical/statistics & numerical data , Drainage/trends , Electrocoagulation/adverse effects , Facial Paralysis/epidemiology , Female , Humans , Length of Stay/statistics & numerical data , Male , Meta-Analysis as Topic , Middle Aged , Operative Time , Outcome Assessment, Health Care , Postoperative Period , Surgical Instruments/adverse effects