Bipolar Electric Coagulation Under Different Power For Adult Goat Mesenteric Vascular Research Of Thermal Damage And Hemostatic Effect

Purpose:Laparoscopic minimally invasive surgery is the development trend of gynecological surgery, laparoscopic minimally invasive surgery has been widely applied in the field of gynecological surgery, such as laparoscopic ovarian cyst removal surgery, laparoscopic uterine flesh tumour removal surgery, laparoscopic total hysterectomy is already a major provincial hospitals and township-level basic-level hospitals generally carry out the operation project。In spite of all kinds of new laparoscopic electric surgical instruments appeared constantly and application, in recent years we have developed ultrasonic knife, Ligasure vessel loop system, etc, as some new types equipment with good hemostatic effect and easy to operate, but the traditional electric surgical instruments, such as unipolar electric coagulation and bipolar electric coagulation, on the basis of their economic, fast and convenient advantages along with the development of the laparoscopic minimally invasive surgery and more popularization. The heating effect injury of unipolar electric coagulation and the bipolar electric coagulation is regarded as one of the biggest defects, the results of severe surgical complications such as ureter fistula, intestinal fistula and urinary bladder damage reports emerge in endlessly. Despite surgery doctors have a preliminary understanding on this issue, but due to know the few details and deal with it irrational.The provincial hospital doctors who have better conditions focus on using more advanced and secure new electricity surgical instruments, such as ultrasonic knife, Ligasure,, minimize the use of unipolar electric coagulation and bipolar electric coagulation; The basic-level hospital doctors who have poor condition, or settle for second best, using traditional cold knife, silk suture, cannot carry out minimally invasive surgery, or feeling the stones across the river, in frequent complications for the empirical summary of failure. Among them, the bipolar electric coagulation instrument suitable for operation of power and right using method, there is still no complete, more strategic basic research and summary, so the basic research and summarization of the bipolar electric coagulation heating injury and the hemostatic effect has very important practical value and significance.Methods:we electric coagulation and cutting off Adult goat upon mesenteric vessels in the body,using the bipolar electric coagulation under different power solidification and separate the living goat mesenteric vascular tissue of similar to the specifications, (using vernier caliper to measure the goat screening specimens of mesenteric vascular diameter between 3.0-5.0 mm), postoperative gathering around a certain normal tissue by setting off a goat mesenteric vascular tissue as specimens,50w-80w power is divided into 6 groups,and different under different power 10 to 13 copies of a total of 69 copies. First, we macroscopic observe gross injury and the surrounding color and measured generally zone of injury, and then, the specimen fixed with 10% formaldehyde solution, paraffin embedding section, HE staining and observed under light microscopy histopathological changes of each specimen damage,and image acquisition with application of NIS. The Elements F2.30 image acquisition software,and analysis image,measuring range of each specimen tissue thermal damage with application of NIS. Elements BR3.0 image analysis software, accurate to 0.01 mm; In the end, we applicate SPSS19.0 software system to process, the measured data of t test method is used to compare the the difference between the groups, with P< 0.001 for the significant difference. Variance analysis and multiple comparison test, further understand the use of a bipolar electric coagulation power and scope of thermal damage with tissue specimens with or without linear correlation.Results:1 The bipolar electric coagulation under different power lead to goat mesenteric vascular tissue thermal damage range between difference (P< 0.001), the smaller the power, the less heat transfer zone of injury.2.Under the high power (70 w,75 w,80 w), the vascular closing probability is one hundred percent, but the thermal damage area is larger, under the specific power (55 w,60 w,65 w) bipolar an electrocautery unit three groups compare differences between the vascular closing probability,60w power bipolar electric coagulation single highest success rate of hemostasis.Conclusion:This experiment at home and abroad for the first time in adult goat mesenteric vascular tissue for experimental specimens study compared laparoscopic surgery in the bipolar electric coagulation of tissue thermal damage range and vascular closing probability under different power. According to the bipolar electric coagulation under different operating power caused by the thermal damage scope and vascular closing probability data comprehensive analysis, indicates that a bipolar electric coagulation at 60 w power for the most suitable for work, has very low thermal damage range, and has good vascular closing probability, is the most ideal power in the experiment. The actual work in complex, if blood vessels are closed hemostatic effect is poor, in order to increase vascular closing probability, to 70 w power also can consider to choose, only thermal damage range increased significantly. This conclusion is based on animal experiments, still need through the clinical practice and further study of fundamental experiments verify operation.