Abstract:
BACKGROUND AND PURPOSE:Current urologic laparoscopic procedures include preservation of locoregional nerve fibers. The use of electrical coagulation is limited because of tissue conductance of current and heat production. While ultrasonic coagulation does not use electricity, heat is still produced. We designed an animal model to characterize the heat spread around ultrasonic devices and assess whether it is neurodestructive. MATERIALS AND METHODS:10 rats were anesthetized; their skin was reflected, exposing the muscles. An ultrasonic probe was introduced into the tissue, and coagulation was performed for 10 seconds. Tissue temperature was measured using four thermocouples, at distances of 4, 8, 12, and 16 mm from the probes and in a circumferential manner. Thermal mapping of the probes was performed with an infrared camera. Further, four rats were anesthetized; the skin above their inner thighs was reflected bilaterally exposing the "nervus ischiadicus." Coagulation was performed in varying distances from the nerve on one side while the other served as control. One week later, the animals were sacrificed, and the nerves were obtained. Silver staining was used to assess the vitality of the axons. RESULTS:In distances of 4 to 8 mm from the device, temperatures as high as 81°C were recorded, and silver staining showed severe axonal damage. CONCLUSIONS:Although ultrasonic coagulation is efficient, local heat production may reach neurodestructive levels with a typical tissue distribution pattern. These features should be addressed during laparoscopic dissection and when considering nerve-sparing procedures.
journal_name
J Endouroljournal_title
Journal of endourologyauthors
Katz R,Danai Y,Peleg E,Gofrit ON,Pode D,Adler D,Hur TBdoi
10.1089/end.2010.0031subject
Has Abstractpub_date
2010-11-01 00:00:00pages
1857-62issue
11eissn
0892-7790issn
1557-900Xjournal_volume
24pub_type
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journal_title:Journal of endourology
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pub_type: 临床试验,杂志文章,多中心研究
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journal_title:Journal of endourology
pub_type: 杂志文章,评审
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journal_title:Journal of endourology
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