title: Bumping phenomenon during continuous coagulation with bipolar forceps.
abstract: During continuous bipolar coagulation, the coagulum sometimes ruptures suddenly and audibly, leading to hemostasis failure and damage to the surrounding tissues. Such coagulum rupture is a phenomenon that is similar to microwave bumping, which occurs because of unequal heat distribution as a result of sudden elevation in temperature. The present study investigated the conditions under which bumping can occur during bipolar coagulation using samples of whole blood. Two types of bipolar forceps were assessed: forceps with gold-plated tips and IsoCoolTM forceps. The time until the bumping phenomenon occurred was measured, and the occurrence rate of bumping was calculated. Thermal characteristics were then assayed using a thermographic camera. As the output of the bipolar coagulator increased, the time until bumping decreased whereas the occurrence rate of bumping during coagulation increased. At lower outputs, the occurrence rate of bumping was significantly lower using IsoCoolTM forceps than that using forceps with gold-plated tips (p<0.0001). Furthermore, bumping during coagulation could be prevented if the tips of the forceps at the coagulation site were repeatedly opened and closed. The bumping phenomenon is influenced by various factors such as heat, electrical power, equipment, and coagulation technique. Neurosurgeons should understand the technical certain aspects of these surgical tools and develop appropriate advanced techniques for temperature control.
authors.affiliation: Department of Neurosurgery, Sapporo Medical University, Hokkaido, Sapporo, Japan. tmikami@sapmed.ac.jp
authors.forename: Takeshi
authors.initials: T
authors.lastname: Mikami
authors.forename: Masahiko
authors.initials: M
authors.lastname: Wanibuchi
authors.forename: Nobuhiro
authors.initials: N
authors.lastname: Mikuni
mesh_terms: D001777:Blood Coagulation; D004564:Electrocoagulation / Q000295:instrumentation*; D004867:Equipment Design; D006801:Humans; D066298:In Vitro Techniques; D007431:Intraoperative Complications / Q000175:diagnosis* / Q000209:etiology*; D012421:Rupture; D013016:Sound; D013525:Surgical Instruments; D013817:Thermography