Comparatıve assessment of thermal ınjury ınduced by bıpolar electrocautery systems ın a porcıne model

Abstract

Background: Bipolar electrocautery systems used during neurosurgical procedures have been shown to induce thermal injury to surrounding tissue. The goal of this study was to compare the thermal injury induced by two different systems commonly used in neurosurgical procedures (Silverglide by Stryker Corporation and SpetzlerMalis by Codman Neuro), with that of a newly introduced device (TRIOwand by NICO Corporation). Methods: A farm swine underwent craniectomy and durotomy with subsequent exposure of cortical brain tissue. Electrocoagulation for the duration of 3 s was conducted with three different bipolar systems under comparable power settings. The maximal depth of thermal injury and mean area of injury in Hematoxylin and Eosin stained slides were quantified using Image J. The tissues were evaluated for vacuolization and ischemic damage. One-way ANOVA followed by post hoc Tukey test was utilized for statistical analysis. Alpha level was set at 0.05. Results: TRIOwand lesions showed less depth of injury when compared to both Spetzler-Malis (P < 0.001) and Silverglide lesions (P = 0.048). Silverglide lesions showed significantly less depth of injury when compared to SpetzlerMalis lesions (P < 0.001). The injury area induced by the TRIOwand was significantly less than that of Spetzler-Malis (P < 0.001) and Silverglide systems (P < 0.001). Ischemic changes and vacuolization were seen in all three groups. Conclusion: Thermal damage is induced to varying extents by all bipolar systems. In this porcine model and under the conditions tested, bipolar cauterization with the TRIOwand resulted in less depth and decreased mean area of injury. Further studies are needed to characterize the injury caused by different bipolar systems with other settings and under surgical conditions in humans.

Strongly Adhesive, Self-Healing, Hemostatic Hydrogel for the Repair of Traumatic Brain Injury

“…Uncontrolled brain damage occurring after traumatic brain injury (TBI) results in high global mortality and disability rates. , The impact of external force on the head results in irreversible effects on the structure and function of the brain, including changes in consciousness, cognitive and memory impairment, neuro-muscular dysfunction, and emotional and behavioral issues . The treatment of TBI presents a particularly challenging surgical dilemma, as effective clinical treatment methods are yet to be developed. , Surgical intervention to stop bleeding through electrocoagulation is presently the sole clinical method for managing TBI and small cerebral artery injuries. , However, this approach contributes to secondary tissue loss, impaired regeneration, and associated functional impairments due to factors such as stretching during surgery and thermal damage caused by electrocoagulation. , Even after timely and successful treatment, most TBI survivors still require long-term care or rehabilitation, , making repair and rehabilitation a long-term challenge . Recently, biomaterials have shown promise in addressing TBI.…”

“…6,7 However, this approach contributes to secondary tissue loss, impaired regeneration, and associated functional impairments due to factors such as stretching during surgery and thermal damage caused by electrocoagulation. 8,9 Even after timely and successful treatment, most TBI survivors still require long-term care or rehabilitation, 10,11 making repair and rehabilitation a long-term challenge. 12 Recently, biomaterials have shown promise in addressing TBI.…”