Harmonic Scalpel and Electrothermal Bipolar Vessel Sealing System in Head and Neck Surgery

Abstract

Our data suggest EBVS and HS can be considered valid and safe devices for ENT surgery.

Intraoperative monitoring of marginal mandibular nerve during neck dissection

“…Neck dissection is one of the main procedures in oncologic head and neck surgery and is not free from complications. Nerve injuries are among the most fearsome complications of this procedure, and damage to nervous structures can result from stretching, pressuring, cutting, and temperature variations on connected tissues caused by new generation scalpels . In particular, marginal mandibular nerve injury results in a severe aesthetic deficit and can occur in many different procedures, such as parotidectomy, submandibular gland excision, carotid endarterectomy, open reductions of mandibular angle fractures, rhytidoplasties, submental flap harvesting, and neck dissection .…”

“…Nerve injuries are among the most fearsome complications of this procedure, and damage to nervous structures can result from stretching, pressuring, cutting, and temperature variations on connected tissues caused by new generation scalpels. 35 In particular, marginal mandibular nerve injury results in a severe aesthetic deficit and can occur in many different procedures, such as parotidectomy, submandibular gland excision, carotid endarterectomy, open reductions of mandibular angle fractures, rhytidoplasties, submental flap harvesting, and neck dissection. 2,4,5 The crossing point between the facial vascular pedicle and the marginal mandibular nerve, as it becomes more superficial along the mandible, is the most dangerous zone when trying to preserve nerve integrity.…”

Effect of Monopolar Cutting Mode against Bipolar Diathermy on Surgical Dissection of Microvessels

“…This is most likely from the lower power used for BD which will require more time to achieve the coagulation and thus may transmit the higher amount of heat around the surrounding tissue. 16,17 It has been reported that even using BD can raise the temperature to 85 to 100°C due to the longer time needed to achieve the targeted coagulation compared with the MD properly. 18,19 In MD, tissue is cut via vaporization, which can be visually confirmed, but using BD desiccates the tissue instead of vaporizing thus requiring a longer time for sufficient coagulation.…”

Energy based surgical instruments : With particular focus on collateral thermal injury

“…e classi cation of neural thermal damage we used in the rst two papers was developed by our collaborator dr Nordborg. is has later been described as the Carlander classi cation system [122,123].…”