TISSUE THERMOMETRIC CHARACTERISTICS IN THE INTERVENTION AREA DURING ELECTROSURGICAL VAGINAL HYSTERECTOMY

Safe and effective hemostasis is one of the most important factors in minimally invasive surgery. Objective. To measure the maximum temperature of the working branches of bipolar tools used for hemostasis during vaginal hysterectomy (VH). Subjects and methods. The investigation enrolled 29 patients who had undergone VH. The female patients were divided into three groups according to the tool used for tissue coagulation. A BiClamp was used in Group 1 (n = 10); a TissueSeal Plus clamp was applied in Group 2 (n = 10), and a Thunderbeat clamp was employed in Group 3 (n = 9). The maximum temperature was measured using a Fluke FLK TiS 40 9HZ infrared imaging camera. Results. The median maximum temperature of the branches on electroligation with a BiClamp was 113.20°С; that at the coagulation boundary was 71.65°С. On ligation with a Thunderbeat clamp, the temperature of the branches was 165.49°С; that at the coagulation boundary was 54.59°С. On ligation with a TissueSeal Plus clamp, the temperature of the branches was 84.63°С; that at the coagulation border was 47.78°С (p = 0.0001). The median maximum temperature of tool branches on electroligation and that at the border of coagulation with intact tissue were much lower than that with TissueSeal Plus than with BiClamp and Thunderbeat (H value, 24.9;p < 0.0001). Conclusion. The possibility of lateral heat transfer varies with the type of a tool and the maximum temperature on its branches. This investigation demonstrates that electrosurgical hemostasis using the TissueSeal Plus bipolar forceps shows a number of advantages over that with the BiClamp bipolar forceps and Thunderbeat for VH. TissueSeal Plus has demonstrated the safest coagulation with the lowest branch temperatures.

BiClamp, TissueSeal Plus Comfort, Thunderbeat, vaginal hysterectomy, infrared imaging camera, BiClamp, TissueSeal Plus Comfort, Thunderbeat