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At least 613 records · Page 34Linked to original sources

PubMed2003

Malignant conversion of florid oral and labial papillomatosis during topical immunotherapy with imiquimod.

We report a case of a 61-year-old woman suffering from florid oral papillomatosis with a squamous-cell cancer of the floor of the mouth, which was removed by scalpel surgery combined with a radical neck dissection in 1996. Between 1996 and 2000 several histologically benign papillomatous lesions of mouth and lips were removed with laser and electrosurgery. However, the lesions recurred. In July 2000 hyperkeratotic, wart-like lesions were present at the lower and upper lips and at the right angle of the mouth and the adjacent oral mucosa. Overnight treatment with a topical 5% imiquimod cream on a Monday-Wednesday-Friday schedule was initiated. However, due to severe irritation and pain the application had to be reduced to 4 h per night, three times a week, followed by a therapy-free interval of 2 weeks. Despite this treatment consisting of four cycles of 3 weeks (1 week treatment and 2 weeks pause), the lesions increased markedly in size. A biopsy taken from the tumorous lesion from the right angle of the mouth proved to be a squamous-cell carcinoma. The tumors of the labial and oral mucosal sites as well as the right submandibular lymph nodes were removed by wide scalpel excision. The lips were reconstructed by plastic surgery. 24 months after surgical intervention no recurrence nor metastasis to lymph nodes or distal sites were observed.

Aminoquinolines↗

PubMed2001

UltraCision or high-frequency knife in transanal endoscopic microsurgery (TEM)? Advantages of a new procedure.

The potential advantages of ultrasound dissection using UltraCision (UC) an ultrasonically activated scalpel, rather than conventional electrosurgery (ES) were investigated retrospectively in 63 patients following transanal endoscopic microsurgery (TEM) in 22 cases of rectal carcinoma (16 pT1, four pT2, two pT3), 40 cases of rectal adenoma >2 cm, and one neurinoma. In all, 21 patients (13 adenomas, seven carcinomas, and one neurinoma) were operated with UltraCision (Ethicon, Norderstedt, Germany), whereas 42 patients (27 adenomas, 15 carcinomas) were treated with conventional electrocautery. All tumors were completely excised (R0) in both groups. We encountered a total of nine complications, seven after ES and two after UC use. Surgical reintervention was necessary in three cases (4.7%), exclusively following resection by ES. There were five cases of tumor recurrence (7.9%), once again only in the ES group. The advantages of ultrasound dissection are magnified under the particular conditions of minimally invasive endoscopic rectum surgery by means of TEM. In principle, all the known risks associated with the application of electric current can be avoided by using ultrasound technology.

Adenoma↗

PubMed1975

Electromicrosurgery and salpingostomy: long-term results.

It seems that a technique which is as atraumatic and as bloodless as possible gives good results. This "atraumatic and bloodless" surgery is possible by means of electrosurgery, refined to a form of microsurgery. The author presents his long-term results (observations over 8 years). Pregnancies: 63 per cent; resulting in 24 per cent ectopic pregnancies and 36 per cent live births; 3 per cent pregnant pregnant at present.

Electrosurgery↗

PubMed1993

Laparoscopic capacitance: a mystery measured. Experiments in pigs with confirmation in the engineering laboratory.

OBJECTIVES: Our purpose was to determine whether capacitive currents induced in operative laparoscopes during endoscopic electrosurgery can cause unintentional injury and to measure these currents in the laboratory. STUDY DESIGN: In five anesthetized live pigs we tested whether capacitive currents generated in operative laparoscopes by unipolar instruments cause serosal injury. These currents were then measured in the clinical engineering laboratory. RESULTS: In the setting examined by us serosal injury by capacitive currents occurred only with high generator output power. In the laboratory the maximum power of these capacitive currents measured 2.5 W. CONCLUSIONS: Capacitive coupling between unipolar instruments and 10 mm operating laparoscopes requires relatively high generator output to cause serosal injury. Lower generator output settings may cause injury with electrosurgical generators capable of higher voltages than the units used in this study (Valleylab SSE2L and Force 2).

Abdominal Muscles↗

PubMed1991

A practical approach to laparoscopic cholecystectomy.

A prospective study of 500 consecutive cholecystectomies was initiated with the introduction of laparoscopic cholecystectomy. Laparoscopic cholecystectomy was attempted in 96% of patients presenting with primary gallbladder disease and was completed in 95%. There were no deaths or bile duct injuries. Two patients undergoing laparoscopic cholecystectomy were transfused for postoperative bleeding, and only one patient required reoperation for any reason. A prospective study showed reduced operating time (20 minutes) and patient charges ($546) using electrosurgical dissection compared with laser. Reusable trocars were used without any associated injury or morbidity. An effective strategy for selective cholangiography was developed based on patient history, liver enzymes, and common duct diameter. In conclusion, laparoscopic cholecystectomy appears to be a safe operation. The cost-effectiveness of laparoscopic cholecystectomy can be enhanced ($1,271) with no loss of patient benefit using the combination of electrosurgery, reusable trocars, and selective cholangiograms in low-risk patients.

Adolescent↗

PubMed1976

A histologic comparison of effects of electrosurgical resection using different electrodes.

Electrosurgery is a helpful adjunct to restorative dentistry, yet there often is damage to underlying connective tissue. In this study, small loop electrodes demonstrated a wider area of coagulation necrosis than was found with needle electrodes. In all instances, coagulation necrosis as a result of heat was noted. To help minimize tissue damage, very fine wire electrodes should be used, and entry into deep tissue layers should be avoided.

Electrodes↗

PubMed1983

Comparative study of gingival retraction methods.

The effects of electrosurgery, retraction cord, and the rotary gingival curettage technique were tested clinically and histologically in dogs. Postoperative periods analyzed ranged from 6 hours to 14 days. All methods induced some kind of minor damage. Recession of clinical magnitude was induced only by rotary gingival curettage. Apical migration of the junctional epithelium was not seen.

Animals↗

PubMed1986

Electrosurgical management of hyperplastic tissue.

Electrosurgery is a safe, effective modality for tissue management in conjunction with restorative dentistry. It can be used to remove redundant tissue to gain access for tooth preparation, develop a gingival trough around the margins of a prepared tooth for an accurate impression, control hemorrhage, remove opercula, and plane and reshape tissue of an edentulous area for the construction of a hygienic and esthetic pontic.

Dental Cavity Preparation↗

PubMed1983

Lateral heat production secondary to electrosurgical incisions.

Adverse healing responses, including necrosis of soft tissue and sequestration of alveolar bone, have been reported following the use of electrosurgery for intraoral incisions. These responses are usually attributed to excessive heat accumulation during the surgical procedure. The purpose of this investigation was to measure temperature changes in subadjacent connective tissue during intraoral electrosurgical incisions in palatal mucosa of miniature swine. Results indicate that single electrosurgical incisions should be accomplished at a speed of approximately 7 mm. per second and that successive incisions should be separated by a cooling interval of 8 to 10 seconds to avoid generation of heat sufficient to initiate an adverse healing response.

Animals↗

PubMed1990

Electrosurgical treatment of rhinophyma.

Thirteen patients with moderate to severe rhinophyma were treated with electrosurgery. All patients achieved cosmetic improvement with minimal postoperative complications. Six of 13 patients noted an improvement in nasal breathing after treatment. Patients with a predominantly lobular rhinophyma achieved the best overall results whereas younger patients with generalized nasal hypertrophy were at the highest risk for scarring. This low-cost treatment was associated with few complications and gave excellent cosmetic results. A new clinical classification of rhinophyma has been developed on the basis of the patients in this series.

Adult↗

PubMed2003

Bipolar transurethral resection of the prostate--a new approach.

Benign prostatic hyperplasia (BPH) is a common problem among older men. Transurethral resection of the prostate (TURP) is a common surgical procedure for treatment of BPH. Typically, TURP is performed using monopolar electric current and a wire electrode; however, the irrigating solution used during this procedure has the potential to cause transurethral resection (TUR) syndrome. A new technology uses bipolar electrosurgery, which creates less risk of electrical shock, and saline irrigation, which eliminates the risk for TUR syndrome.

Aged↗

PubMed2001

Operative transvaginal hydrolaparoscopy for treatment of polycystic ovary syndrome: a new minimally invasive surgery.

OBJECTIVE: To evaluate a new minimally invasive surgery for treatment of the polycystic ovary syndrome (PCOS) in clomiphene-resistant infertile women. DESIGN: Prospective study. SETTING: University teaching hospital. PATIENT(S): Thirteen clomiphene citrate-resistant anovulatory women with PCOS. INTERVENTION(S): Operative transvaginal hydrolaparoscopy (THL) using a coaxial bipolar electrode. MAIN OUTCOME MEASURE(S): Feasability, ovulation rate, and pregnancy rate. RESULT(S): Ovarian drilling was performed by THL in all patients; no surgical complications occurred. Mean (+/-SD) duration of follow-up time was 6.3 +/- 3.3 months. Six patients recovered to have regular ovulatory cycles. Six pregnancies occurred; three were spontaneous, two occurred after stimulation and intrauterine insemination, and one occurred after IVF. The cumulative pregnancy rate was 33% at 3 months after THL and 71% at 6 months after THL. No miscarriages occurred. CONCLUSION(S): Transvaginal hydrolaparoscopy with ovarian drilling using bipolar electrosurgery appears to be an alternative minimally invasive in patients with PCOS who are resistant to clomiphene therapy.

Adult↗

PubMedDate not supplied

Conducted current on guidewires in single lumen papillotomes.

An in vitro electrical circuit was designed to measure conducted current in plastic-coated guidewires and standard guidewires inserted in a single lumen papillotome. Single lumen papillotomes, which are more flexible than double lumen papillotomes, require the removal of the guidewire before electrosurgery due to concern over conducted current. In an in vitro electrical circuit, equivalent current was measured in both the papillotome wire and the standard guidewire. Plastic-coated guidewires did not allow any current flow. The advantages of flexible single lumen papillotomes and maintenance of deep biliary cannulation over a guidewire may be combined if insulated plastic-coated guidewires are used.

Ampulla of Vater↗

PubMed1989

Overview of the clinical electrophysiology study.

Clinical electrophysiology testing is now a standard, useful technique for assessing patients with bradyarrhythmias or tachyarrhythmias. The technique requires specialized training and equipment. The recording equipment and program stimulator have evolved to sophisticated devices allowing accurate reproduction of intracardiac electrograms and timing of programmed extrastimuli. Electrophysiologic studies are useful for determining the mechanisms of a tachycardia or bradycardia and identifying the most appropriate therapy, whether it be pacing, antiarrhythmic medications, transvenous ablation, or electrosurgery.

Anti-Arrhythmia Agents↗

PubMed1980

Experimental subglottic stenosis: histopathologic and bronchoscopic comparison of electrosurgical, cryosurgical, and laser resection.

Controversy continues over the optimal method of resecting subglottic stenosis. Electrosurgery, cryosurgery and laser resection have all had some clinical success. We sought to compare these treatment methods in experimentally-created subglottic stenosis. Subglottic strictures were created transbronchoscopically in newborn lambs by electrocoagulating a rim of mucosa. Four weeks later, all had 20 to 90% occlusion documented bronchoscopically. Control animals were found to have dense submucosal fibrosis in the cricoid area. Remaining experimental animals were treated with: (1) electrosurgical resection; (2) cryosurgical treatment; (3) Neodymium-yag (Nd:Yag) laser at 20 watts; (4) Nd:Yag laser with 40 watts; or (5) carbon dioxide laser at 10 watts. Animals from each group were sacrificed at 5 and 30 days postresection and the tracheas were examined grossly and microscopically. Animals sacrificed at 30 days postresection were bronchoscoped at weekly intervals. Cryosurgical and electrosurgical resection resulted in 1-3 mm of thermal damage adjacent to the margin of resection at 5 days post-treatment. Mucosal ingrowth and healing were rapid and there was no development of stenosis or damage to underlying structures. Use of the Nd:Yag laser resulted in 10-20 mm of surrounding damage in animals sacrificed at 5 days. At 30 days posttreatment, there was mucosal healing but extreme underlying damage and redevelopment of stenosis at the level of treatment. The carbon dioxide laser-treated animals showed thermal damage present up to 2 mm in depth from resected areas at 5 days post-treatment. Mucosal regeneration proceeded rapidly. This study indicates that electrosurgical and cryosurgical resection for experimental subglottic stenosis create minimal thermal damage and are associated with comparably acceptable rates of mucosal ingrowth and healing. The carbon dioxide laser created comparable to slightly decreased thermal damage but suffers at present from lack of optimal visualization of the subglottic lesion.

Animals↗

PubMed1989

A comparison of urologic application of bipolar versus monopolar five French electrosurgical probes.

Urologic endoscopic procedures often involve electrosurgery. Recently bipolar probes have become commercially available. This study compares monopolar and bipolar electrosurgical probes in relation to power losses in urologic endoscopic instruments with the infusion of sterile water and saline, and the power transmitted by probes to tissue correlated to tissue destruction in each fluid. The power losses through each instrument in both solutions were minimal. The bipolar electrode functioned at a much lower power output than did the monopolar electrode. The bipolar probe was also more effective in saline than sterile water. The depth, width and volume of tissue damage for both electrodes were found to vary with generator power output. The data shows the burns had similar diameters for both probes but the bipolar probe caused significantly less burn depth than the monopolar probe. These initial studies indicate that bipolar electrodes can function in normal saline with less depth damage compared to the monopolar probe.

Animals↗

PubMed1975

Bladder explosions during transurethral surgery.

Gases liberated during transurethral electrosurgery are common to all tissues with hydrogen produced in high concentration. We postulate that the majority of hydrogen is derived from electrolysis of intracellular water. Only with the addition of outside oxygen does the gaseous mixture become potentially explosive.

Electrolysis↗

PubMed1996

Transurethral electrovaporization of bladder cancer.

OBJECTIVES: To describe the use of transurethral electrovaporization in the treatment of large superficial bladder tumors. METHODS: The records of 9 consecutive patients with large superficial bladder tumors treated by transurethral electrovaporization were retrospectively reviewed. All patients underwent vaporization of superficial tumor with either a grooved or smooth rollerball electrode. Tumor characteristics, blood loss, operative time, and length of hospital stay were recorded. RESULTS: A total of 12 bladder tumors were treated in 9 patients. The mean tumor size was 4.3 cm in diameter and the mean operative time was 80 minutes with a range of 60 to 100 minutes. No complications were noted and only 1 patient required a transfusion. The mean fall in hematocrit was 0.7%. CONCLUSIONS: Transurethral electrovaporization represents a new application of electrosurgery that is safe and effective in the treatment of large superficial bladder tumors.

Aged↗