Comparison of two radiofrequency-based hemostatic devices

Purpose: To characterize the coagulation zones created by two radiofrequency (RF)-based hemostatic devices: one comprised an internally cooled monopolar electrode and the other comprised externally irrigated bipolar electrodes (saline-linked). Materials and methods: RF-induced coagulation zones were...

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Detalles Bibliográficos
Autores: Moll, Xavier|||0000-0002-2992-9361, Fondevila, Dolors|||0000-0001-7443-0175, García Arnas, Félix|||0000-0001-6651-3173, Burdío, Fernando|||0000-0003-3038-0086, Trujillo, Macarena, Irastorza, Ramiro M., Berjano, Enrique|||0000-0002-3247-2665, Andaluz Martínez, Anna|||0000-0001-8097-8110
Tipo de recurso: artículo
Fecha de publicación:2022
País:España
Institución:Universitat Autònoma de Barcelona
Repositorio:Dipòsit Digital de Documents de la UAB
Idioma:inglés
OAI Identifier:oai:ddd.uab.cat:306497
Acceso en línea:https://ddd.uab.cat/record/306497
https://dx.doi.org/urn:doi:10.1080/02656736.2022.2140840
Access Level:acceso abierto
Palabra clave:Animals
Catheter ablation
Cooled electrode
Hemostatic device
Hemostatics
Liver surgery
Radiofrequency
Thermal ablation
Saline-linked
Descripción
Sumario:Purpose: To characterize the coagulation zones created by two radiofrequency (RF)-based hemostatic devices: one comprised an internally cooled monopolar electrode and the other comprised externally irrigated bipolar electrodes (saline-linked). Materials and methods: RF-induced coagulation zones were created on ex vivo and in vivo porcine models. Computer modeling was used to determine the RF power distribution in the saline-linked device. Results: Both external (irrigation) and internal cooling effectively prevented tissue sticking. Under ex vivo conditions in 'painting' application mode, coagulation depth increased with the applied power: 2.8 - 5.6 mm with the 3-mm monopolar electrode, 1.6 - 6.0 mm with the 5-mm monopolar electrode and 0.6 - 3.2 mm with the saline-linked bipolar electrodes. Under in vivo conditions and using spot applications, the 3-mm monopolar electrode created coagulation zones of similar depth to the saline-linked bipolar electrodes (around 3 mm), while the 5-mm monopolar electrode created deeper coagulations (4.5 - 6 mm) with less incidence of popping. The presence of saline around the saline-linked bipolar electrodes meant that a significant percentage of RF power (50 - 80%) was dissipated by heating in the saline layer. Coagulation zones were histologically similar for all the tested devices. Conclusions: Both external (irrigation) and internal cooling in hemostatic RF devices effectively prevent tissue sticking and create similar coagulation zones from a histological point of view. Overall, saline-linked bipolar electrodes tend to create shallower coagulations than those created with an internally cooled monopolar electrode.