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PubMed1975

[Effect of the destruction of the pars intercerebralis on molting in Aeshne cyanes Müll. larva (Insecta, Odonata)].

The cauterization of the pars intercerebralis blocks the moulting process in Aeshna. The critical period for this experiment has been determined in the 2 last instars. After this period brain cautery only delays moulting without preventing this process. Cauterization of the pars intercerebralis after the critical period of the prothoracic gland activity does not affect moulting in any way.

Age Factors↗
PubMed2000

Origin of metallic particles resembling microcalcifications on mammograms after use of abrasive cautery-tip cleaning pads during breast surgery: experimental demonstration.

PURPOSE: To determine if the act of cleaning a cautery tip with an abrasive pad dislodges radiopaque particles that can be transferred to breast tissue during surgery, thereby mimicking microcalcifications at mammography. MATERIALS AND METHODS: Mock breast surgery was performed by cauterizing bovine liver or fresh, normal, human breast tissue. The cautery tip was rubbed against a cleaning pad five to 20 times in the manner used intraoperatively and was touched on separate breast tissue specimens two to six times. Specimen radiography was then performed. Thirty-six breast specimens were used in three experiments, including 28 used for the experimental conditions and eight control specimens. RESULTS: Particles collected from the cleaning pads resembled microcalcifications. After cauterization of liver, breast tissue, or both, in series, particles transferred from the cautery tip to breast tissue specimens could be identified on specimen radiographs. Transfer of particles after cautery of breast tissue occurred with increased numbers of rubs and specimen contacts. CONCLUSION: Radiopaque aluminum oxide particles from abrasive cautery-tip cleaning pads can be dislodged and transferred to breast tissue during surgery. Scrutiny of high-detail, spot-compression, magnification mammograms will help identify these particles. Simple measures to mitigate particle transfer during breast surgery can prevent this problem and obviate a potential second procedure to remove particles mistaken for microcalcifications.

Aluminum Oxide↗
PubMed1994

Video-endoscopic facelift.

We report on our experience with 22 video-endoscopic facelift cases. We prefer the term facelift to rhytidoplasty because with the endoscopic facelift facial wrinkles are not eliminated by resecting skin but by elevating facial structures, treating the facial muscles, and improving facial contour. We treat the frontal region subperiosteally by elevating the eyebrows, minimizing wrinkles, and avoiding the coronal incision. The midthird of the face is treated subcutaneously by dissecting the skin from the SMAS, from the ear to the nasolabial fold. The endoscope is inserted through one incision and a cautery through the other. Blood vessels are cauterized. Plicating the SMAS and premalar fat pads to the temporal fascia treats the nasolabial fold and the "jowl." In the cervical region we treat the plastysma, and, with superficial liposculpture, remove excess fat and provoke skin retraction, which allows us to treat older patients who have a more flaccid skin tone. The endoscope is used to help the cauterizing and the suturing. The platysma can be sutured in the midline, if necessary. The cervical mental angle can be redefined with a Goretex 0 suture that passes from mastoid to mastoid. Modified instruments and different approaches to this technique can be expected, but we believe video endoscopy is going to have an important impact on the future of plastic surgery.

Endoscopy↗
PubMed1992

Preliminary experience using an ultrasonic aspirator for laparoscopic cholecystectomy.

An ultrasonic aspirator (Olympus) specially designed for laparoscopic surgery, which also includes cautery and suction-irrigation systems, was evaluated in 40 patients undergoing laparoscopic cholecystectomy. The generating power of each system is controlled by hand or foot switches, and most operating procedures could easily be performed through a 10 mm trocar inserted through the abdominal wall. The ultrasonic aspirator successfully fragmented and aspirated soft tissue, allowing a precise differentiation between the cystic duct and artery, small vessels, lymphatics and fibrous tissue. Removal of the gallbladder could be performed successfully using the cautery and ultrasonic aspirator, whereby parts of cauterization or division could easily be identified. Identification of the cystic duct and artery, course of the cystic duct and Hartmann's pouch in the same field of vision was possible which is important for avoiding major complications such as injury of the common bile duct. No complications were seen during or after surgery in any of the patients.

Cholecystectomy, Laparoscopic↗
PubMed1979

A simplified and efficient method for treating varicose veins.

Stripping the saphenous vein and manual excision of varicose veins has been the popular operative treatment for many years. During this 2- to 4-hour procedure, the patient must be rotated from the supine to the prone position in order to excise the collateral veins. These maneuvers are time-consuming and result in contamination, dozens of unsightly scars, and incomplete destruction of many of the small tortuous varicosities. In 705 patients we have substituted limited excision when possible and high-frequency cautery methods to destroy the venous tributaries. Cauterization, accomplished by introducing a probe subcutaneously through a 2 mm skin incision which requires no sutures for closure, affords excellent treatment for the troublesome smaller tortuous veins. The recurrence rate depends on the primary cause of the varicosities and is roughly the same in both types of operative procedures. The advantages of the latter procedure are shorter operating and anesthesia times, minimal infection rate, substantially less hospital time and cost, and essentially no cosmetic defects.

Arteriovenous Fistula↗
PubMed2003

Superiority of electrocautery over the suture method for achieving cervical cone bed hemostasis.

OBJECTIVE: To compare the efficacy of electrocautery with that of the suture method for achieving hemostasis of the cervical cone bed. METHODS: We performed a retrospective chart review of all patients who underwent cold-knife conization of the cervix over a 5-year period. Patients were categorized into two groups: the cautery group, in which the cone bed was electrocauterized with a hand-held electrocoagulation device; and the suture group, in which hemostasis was achieved by a continuous locking suture placed circumferentially around the cone bed. Outcome measures evaluated include estimated blood loss, operative time, and incidence of complications, including secondary hemorrhage, cervicitis, and cervical stenosis. Data were analyzed by Student t test, chi(2) test, linear regression, and multiple logistic regression where appropriate. RESULTS: There were 156 women in the cautery group and 35 in the suture group. The cautery group had significantly lower estimated blood loss (27 mL versus 101 mL; P <.01) and shorter operative time (34 versus 43 minutes; P <.01) than the suture group. The procedure-related complication rate was 6.4% in the cautery group, compared with 14.3% in the suture group (P = nonsignificant). A higher use of lateral sutures, vasopressors, and thrombotic agents was seen in the cautery group. However, even after adjusting for these variables, mean estimated blood loss (33 mL, P <.01) and mean operative time (34 minutes, P <.01) were significantly less in the cautery group than in the suture group. CONCLUSIONS: Cauterization of the cone bed is superior to suture as a method of achieving hemostasis, with significantly less blood loss and shorter operative time.

Adult↗
PubMed1994

Stability of thrombosis induced by electrocoagulation of rat middle cerebral artery.

BACKGROUND AND PURPOSE: Although it is often assumed in experimental stroke studies that cautery-induced occlusion is permanent, surgeons commonly expect cauterized vessels to recanalize spontaneously. We used the rat middle cerebral artery to determine if electrocoagulation would produce a permanent occlusion in this preparation. METHODS AND RESULTS: A standard bipolar coagulator, calibrated to determine actual power output, was adjusted to induce platelet aggregation in the middle cerebral artery of anesthetized Sprague-Dawley rats without inducing bleeding through the arterial wall. A reliable temporary thrombosis was induced by a Malis Bipolar Coagulator set to deliver 10 bursts of 1.5 seconds each at a rate of 24 min-1 and a power setting of 3 W. This thrombus was responsive to the antithrombotic agent flunarizine. An apparently permanent occlusion was produced by 30 bursts at 3 W followed by 20 bursts at 5 W. To our surprise, seven of seven such occlusions recanalized spontaneously within 4 hours. CONCLUSIONS: The electrocoagulation process commonly used in experimental stroke studies may produce only a temporary occlusion of the rat middle cerebral artery.

Animals↗
PubMed1998

Comparison of coagulation modalities in surgery.

The increase in laparoscopic surgery has resulted in an increased need for a safe and reliable method of obtaining minimally invasive operative hemostasis. Because the traditional "open" methods of controlling bleeding (pressure, tying, and suture ligating) are not as easily applied in the laparoscopic arena, a heavy reliance on forms of tissue and vessel coagulation is necessary. To better assess these forms, we compare monopolar, bipolar, and ultrasound energy, in addition to laser energy used in a novel application. In the first part, 20 rabbit mesenteric arteries that measured 1 to 1.5 mm in diameter were coagulated using each of the technologies. We measured the time to coagulation, the efficacy of hemostasis, lateral tissue damage, and local tissue temperature of the vessels when exposed. Part 2 consisted of a survival study using 12 New Zealand white rabbits. In each of these two groups splenectomies were performed. A laser-heated forceps was compared to a monopolar electrosurgery device for the speed of the operation, blood loss, and adhesion grade at necrosectomy. In addition, the speed to cauterization of the iliac vessels and the amount of tissue damage was measured. These vessels were also examined for the extent of microscopic damage. Bipolar electrosurgery was much slower than the other modalities, while monopolar electrosurgery caused significantly more tissue damage and elevation in lateral tissue temperature. The ultrasound technology and the laser-heated forceps were equally safe and efficacious instruments. There was no significant difference in the ability of the laser-heated forceps or the monopolar cautery to perform the splenectomy safely. However, the forceps cauterized the iliac vessels faster and with less lateral thermal injury than the ultrasound device. Although each instrument has its place in the surgical armamentarium, the ultrasound technology appears to be the safest and most efficacious commercially available device for obtaining hemostasis. The laser, as it is applied in this setting, was also highly effective, but still a prototype device.

Animals↗
PubMed1985

Angiogenic activity in injured rat corneas as assayed on the chick chorioallantoic membrane.

The temporal appearance of an angiogenic effect in chemically cauterized rat corneas was determined by studying the responses that they induced in the vessels of the chick chorioallantoic membrane (CAM). Injured rat corneas were grafted to the CAM from 90 minutes to 7 days after cautery. As controls, uninjured rat corneas and corneas of healthy rats cauterized immediately after death were also grafted. The vascular responses to the grafts were graded in a masked fashion by stereoscopic biomicroscopy on a five-tiered scale, by evaluations of projected colored photographs on the same scale, and by histologic examination of the grafts. Separate coefficients of angiogenesis were determined for the stereoscopic and photographic evaluations. We detected significant differences between corneas of healthy rats that were uninjured or cauterized chemically immediately after death and those that were cauterized in the living rat. Uninjured corneas and corneas cauterized postmortem elicited a mild vascular response in the CAM, as reflected by low coefficients of angiogenesis. Whereas blood vessels were not detected in corneas injured postmortem, some normal corneas vascularized but only after being on the CAM for at least 7 days. The coefficients of angiogenesis of corneas that were cauterized during life were significantly higher than those of both control groups prior to grafting after comparable times on the CAM. Corneas vascularized on the CAM included those that were cauterized as soon as 90 minutes prior to grafting. The strongest vascular responses, as reflected by coefficient of angiogenesis and the frequency of histologically confirmed nucleated avian erythrocytes within intracorneal blood vessels, were found with corneas that were grafted to the CAM 3 days after chemical cauterization. Corneas that vascularized on the CAM were associated with a prominent leukocytic infiltrate suggestively derived from the chick embryo. The results suggest that chemically cauterized rat corneas contain a chemoattractant for polymorphonuclear leukocytes within 90 minutes of injury and that such polymorphonuclear leukocytes or other components of the injured corneas possess the ability to stimulate angiogenesis on the CAM.

Allantois↗