title: Minimal damage during endoscopic latissimus dorsi muscle mobilization with the harmonic scalpel.
abstract: BACKGROUND
  To reduce wound-related complications, a video-assisted surgical technique has been adopted for the mobilization of the latissimus dorsi muscle. We postulated that thermal damage to the muscle might be minimized by using a Harmonic Scalpel instead of electrocautery during this procedure.
  
  
  METHODS
  Canine latissimus dorsi muscles were mobilized through a small incision, assisted by a videoscope. In 6 dogs, dissection with electrocautery was used to mobilize the latissimus dorsi muscle. In 6 other dogs, the Harmonic Scalpel was used. We compared operation times, wound infection rates, histologic changes in the muscles, and ease of handling between these groups.
  
  
  RESULTS
  The operation time was significantly shorter in the Harmonic Scalpel group than in the electrocautery group (61.5 versus 106.5 minutes, p = 0.00014). The Harmonic Scalpel caused less histologic damage to the mobilized muscles and produced less vision-obscuring smoke.
  
  
  CONCLUSIONS
  The Harmonic Scalpel shortens the operation, minimizes muscle damage, and facilitates the performance of video-assisted latissimus dorsi muscle mobilization.
authors.affiliation: Department of Cardiothoracic Surgery, Faculty of Medicine, University of Tokyo, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Inaba
authors.forename: Y
authors.initials: Y
authors.lastname: Kaneko
authors.forename: T
authors.initials: T
authors.lastname: Ohtsuka
authors.forename: M
authors.initials: M
authors.lastname: Ezure
authors.forename: K
authors.initials: K
authors.lastname: Tanaka
authors.forename: K
authors.initials: K
authors.lastname: Ueno
authors.forename: S
authors.initials: S
authors.lastname: Takamoto
mesh_terms: D000818:Animals; D004285:Dogs; D004564:Electrocoagulation; D018482:Muscle, Skeletal / Q000293:injuries / Q000601:surgery*; D013525:Surgical Instruments; D020775:Thoracic Surgery, Video-Assisted / Q000379:methods*