title: Evaluation of thermal damage in a pig model.
abstract: BACKGROUND
  Electrosurgical vessel sealing produces seals that can withstand intraluminal pressures well above the physiological range. In many cases it is more efficient than other methods, such as sutures, hemoclips, and ultrasonic coagulation devices, but bears lateral thermal damage as a side effect. The overall aim of this study was to compare the thermal lateral damage (TL) in vivo versus ex vivo using two different bipolar vessel sealing instruments in an epigastric vein animal model.
  
  
  METHODS
  A total of 96 thermofusions of bilateral epigastric veins were carried out in a prospective, randomized and controlled study design. The laparoscopic BiClamp (type Maryland) and the bipolar clamp Kelly model Clermont-Ferrand were used for ex vivo versus in vivo investigation. After exposure of the two bilateral epigastric veins the proximal sections were bilaterally coagulated in vivo with the two different instruments. For ex vivo coagulation, the uncoagulated section of the vein was removed and coagulated ex vivo. The TL was investigated by infrared measurement, light microscope and histological analysis.
  
  
  RESULTS
  The comparison of the extent of coagulation damage between ex vivo and in vivo coagulation did not differ significantly: no differences between in vivo and ex vivo measurements were found for the Kelly clamp. In the case of the Maryland clamp only a significant greater TL in vivo was shown for stereomicroscopic measurements.
  
  
  CONCLUSIONS
  Ex vivo TL results are comparable with in vivo results. This might prospectively spare in vivo studies with respect to TL and might facilitate the design of future experiments for the development of bipolar electrocoagulation devices.
authors.affiliation: Department of Gynaecology and Obstetrics, University of Tuebingen,   Calwerstr. 7, D-72076 Tuebingen,   Germany.
authors.forename: Ralf
authors.initials: R
authors.lastname: Rothmund
authors.forename: Daniel
authors.initials: D
authors.lastname: Schaeller
authors.forename: Alexander
authors.initials: A
authors.lastname: Neugebauer A
authors.forename: Marcus
authors.initials: M
authors.lastname: Scharpf M
authors.forename: Falko
authors.initials: F
authors.lastname: Fend F
authors.forename: Martin
authors.initials: M
authors.lastname: Schenk
authors.forename: Diethelm
authors.initials: D
authors.lastname: Wallwiener
authors.forename: Bernhard
authors.initials: B
authors.lastname: Kraemer
mesh_terms: D000818:Animals; D004564:Electrocoagulation / Q000009:adverse effects* / Q000379:methods; D005260:Female; D006358:Hot Temperature / Q000009:adverse effects; D010535:Laparoscopy; D011446:Prospective Studies; D011897:Random Allocation; D013552:Swine; D014680:Veins / Q000601:surgery