In vivo evaluation of monopolar versus bipolar electrosurgical polypectomy snares.
The energy required and tissue damage in bipolar and monopolar polypectomy snares were compared in a canine model. The bipolar snare required an average of 34 joules of energy, whereas the monopolar snare required 228 joules to cut the same diameter of gastric mucosa tended into a polypoid structure (p = 0.0005). The reduced energy delivered to the tissue from the bipolar procedure resulted in only 32% average depth of damage to the underlying gastric wall, whereas the monopolar procedure caused an average 69% (p = 0.001). Surgically created polyps required 247 joules and 69 joules for corresponding monopolar and bipolar polypectomy (p = 0.001). The decreased energy required and the correspondingly reduced damage caused to the underlying bowel wall by the bipolar snare should reduce the incidence of perforation and post-polypectomy syndrome. The bipolar snare completes a local circuit about the snare, eliminating the return electrode and, consequently, the possibility of any return electrode burns. The bipolar snare thus provides an added safety margin during polypectomy.
Tucker
R D
RD
Department of Pathology, University of Iowa Hospitals & Clinics, Iowa City.
Platz
C E
CE
Sievert
C E
CE
Vennes
J A
JA
Silvis
S E
SE
D000818:Animals; D004285:Dogs; D004566:Electrodes; D004598:Electrosurgery / Q000295:instrumentation*; D004867:Equipment Design; D005069:Evaluation Studies as Topic; D007414:Intestinal Neoplasms / Q000601:surgery*; D007417:Intestinal Polyps / Q000601:surgery*