SUMMARY: The possibility of using radiofrequency energy (RFE) to produce a suture less anastomosis is attractive both to the military surgeon and on the grounds of cost and simplicity. To investigate this, fresh rabbit aorta was divided lengthways into 4 mm strips and apposed, intima-to-itima. A Valleylab Force 30 Electrosurgery machine supplied RFE at 500 kHz. The energy was applied using standard bipolar forceps and 121 attempts were made to weld the tissue. Seventy seven welds resulted of which 36 were able to withstand a distraction force of greater than O.lN: the strongest weld was disrupted at 0.35N. Intact tissue withstood a distraction force of greater than 2N, whilst sutured joints disrupted at 0.97 N. It is concluded therefore that radiofrequency energy at 500 kHz does not satisfactorily weld vascular tissue.

CorrespondenceEar I y c ho lecystect om y after sphincterotomy for common duct lithiasis Sir We were very interested to read the article by Worthley and Toouli (Br J Surg 1988; 75: 796-8), and Martin and Tweedle's letter (Br J Surg 1989; 76: 101).Worthley and Toouli state that gallbladder non-filling during endoscopic retrograde cholangiopancreatography (ERCP) is a predictive factor of biliary complications that justify cholecystectomy. This idea seems to be disputed by Martin and Tweedle. We performed early and systematic cholecystectomy on elderly or very elderly surgical patients (over 75, average age 83 years) who had undergone sphincterotomy for common duct lithiasis'.We have therefore retrospectively assessed our current data: 36 consecutive patients were treated in this way. The ERCP, performed by the same practitioner, filled the gallbladder in 26 cases (group I) and did not fill it in nine cases (group 11).The percentage of acute cholecystitis (histological result given by the same laboratory) was 65 per cent (17 of 26 patients) for group I and 55percent (five of nine patients) for group 11. No statistical difference was observed between the two groups. For our patients, gallbladder non-filling during ERCP is not a predictive factor of gallbladder problems.

Tattoo removal from the forearm often requires excision and split skin grafting. The authors propose the use of a bloodless field to facilitate accurate dermal peeling, to ensure complete removal of the pigment, and to reduce operative time.

No abstract

SUMMARY: A retrospective analysis of 53 consecutive cases of orchidopexy performed at the British Military Hospital Munster between 1984 and 1988 showed that the average age of referral for orchidopexy was 4 years 7 months and that the average age at surgery for mal/un-descended testes was 5 years exactly. Sixty-four percent of all orchidopexies were carried out before the age of 5 years; 8 percent were carried out by the age of 2 years.