A comparison of monopolar electrosurgery to a new multipolar electrosurgical system in a rat model.

OBJECTIVES/HYPOTHESIS: The purpose of this study is to compare collateral tissue damage and wound healing in incisions created by electro-dissociation and conventional electrosurgery. Conventional electrosurgery has been used as an alternative to the scalpel to improve hemostasis. However, the heat generated by this instrument can cause tissue damage surrounding the incision, limiting its use around nerves and large blood vessels. A new technology, Coblation (Arthrocare Corp., Sunnyvale, CA), uses "electro-dissociation" to achieve similar results by creating charged particles from a conductive medium to make an incision while simultaneously achieving hemostasis. This new approach to electrosurgery may reduce soft tissue damage. METHODS: Two prospective, matched design experiments were performed. In experiment I, both devices were set at the same electrical power in watts and then used to create an incision on the tongue of rats. In experiment II, the electrical power settings of both devices were adjusted until they created incisions of the same size. Epithelial destruction and collateral tissue damage were measured in histologically prepared tissue in both experiments, and the wound healing process was observed in experiment II at 0, 3, 7, and 14 days after surgery. RESULTS: The results showed that the electro-dissociation method created significantly less epithelial destruction and collateral tissue damage in both experiments. Granulation tissue formation was also significantly less extensive in the electrodissociation-induced incision after 7 and 14 days of recovery. CONCLUSIONS: Wound healing may be faster than with conventional electrosurgery if the Coblation device is used.