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Comparative Study
. 2011 Jun;25(6):1827-34.
doi: 10.1007/s00464-010-1474-3. Epub 2010 Dec 8.

Electrocautery causes more ischemic peritoneal tissue damage than ultrasonic dissection

Richard P G ten Broek  1 , Joyce Wilbers, Harry van Goor
Affiliations
Comparative Study

Electrocautery causes more ischemic peritoneal tissue damage than ultrasonic dissection

Richard P G ten Broek et al. Surg Endosc. 2011 Jun.

Abstract

Background: Minimizing peritoneal tissue injury during abdominal surgery has the benefit of reducing postoperative inflammatory response, pain, and adhesion formation. Ultrasonic dissection seems to reduce tissue damage. This study aimed to compare electrocautery and ultrasonic dissection in terms of peritoneal tissue ischemia measured by microdialysis.

Methods: In this study, 18 Wistar rats underwent a median laparotomy and had a peritoneal microdialysis catheter implanted in the left lateral sidewall. The animals were randomly assigned to receive two standard peritoneal incisions parallel to the catheter by either ultrasonic dissection or electrocautery. After the operation, samples of microdialysis dialysate were taken every 2 h until 72 h postoperatively for measurements of pyruvate, lactate, glucose, and glycerol, and ratios were calculated.

Results: The mean lactate-pyruvate ratio (LPR), lactate-glucose ratio (LGR), and glycerol concentration were significantly higher in the electrocautery group than in the ultrasonic dissection group until respectively 34, 48, and 48 h after surgery. The mean areas under the curve (AUC) of LPR, LGR, and glycerol concentration also were higher in the electrocautery group than in the ultrasonic dissection group (4,387 vs. 1,639, P=0.011; 59 vs. 21, P=0.008; 7,438 vs. 4,169, P=0.008, respectively).

Conclusion: Electrosurgery causes more ischemic peritoneal tissue damage than ultrasonic dissection.

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Figures

Fig. 1
Fig. 1
Surgical procedure and microdialysis system. A Median laparotomy. B Two parallel incisions in the parietal peritoneum on both sides of the microdialysis catheter at a distance of 5 mm from the probe. The catheter is connected to a pump and automatic sampler
Fig. 2
Fig. 2
Unrefined data. Microdialysis parameters in animals that had surgery with ultrasonic dissection (UD) (n = 9) or electrocautery (EC) (n = 9)
Fig. 3
Fig. 3
Microdialysis parameters in animals that had surgery with ultrasonic dissection (UD) (n = 9) or electrocautery (EC) (n = 9). Values are expressed as means and 95% confidence intervals. *P < 0.01
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