SAN DIEGO, CA USA (UroToday.com) - As we all know electrocautery has the advantage of allowing precise and effective coagulation of bleeding tissue.
However, when target materials are submerged in fluids such as blood, this fluid must be first removed with a suction or sponge to optimize vision for effective and safe electrocautery. This can cause delays and often requires trained surgical assistance. To help address this shortcoming, a monopolar electrocautery device that utilizes pressurized air to displace fluids was developed by the group at UCSF to improve visualization of otherwise submerged tissues during surgery. Specifically, they designed a monopolar handheld pencil electrocautery device with a nozzle positioned just proximal and adjacent to the electrode blade that expels pressurized air at a rate of 5 liters per minute into the surgical field. This pressurized air is focused at the target tissues and functions to displace the overlying fluid.
As a proof of concept, this novel device was tested using submerged bovine tissue in saline. Specifically, the UCSF group evaluated the depth at which their device could desiccate tissue in comparison to a traditional handheld Bovie. Additionally, shaped patterns were drawn on bovine tissue submerged under 0.5-1 cm. of opaque red fluid, simulating blood. Their pneumatic electrocautery device was then used to displace overlying fluid to reveal the patterns, and they assessed its ability to coagulate the targeted shapes.
The results of their study demonstrated that when bovine tissue was submerged in saline, the traditional Bovie device was able to desiccate tissue at a maximal depth of 0.3 cm. In contrast, their novel pneumatic electrocautery device was able to displace fluid to allow for precise tissue desiccation at a depth up to 1.5 cm. In addition, their device was able to expose submerged tissues, which allowed for effective electrocautery.
In conclusion this novel pneumatic electrocautery device allowed for effective displacement of obscuring overlying fluid, improving visualization for precise electrocautery.
Although very exciting, this initial proof-of-concept project requires further study and validation.
Presented by Herman Bagga, MD at the American Urological Association (AUA) Annual Meeting - May 4 - 8, 2013 - San Diego Convention Center - San Diego, California USA
Department of Urology, University of California San Francisco, San Francisco, CA USA
Reported for UroToday.com by Michael Ordon, MD; UC Irvine Medical Center, Orange, CA USA
