title: Thermal properties of contemporary bipolar systems using infrared imaging.
abstract: BACKGROUND
  Bipolar coagulation has enhanced the capabilities and safety profile of contemporary neurosurgery and has become indispensable in the neurosurgical armamentarium. Nevertheless, significant heat transfer issues remain to be resolved before it can achieve the status of minimal risk.
  
  
  METHODS
  The Codman irrigating forceps, Codman ISOCOOL forceps, and Ellman bipolar forceps, powered by either Synergy or Ellman generators set at various power levels, were compared to investigate the combinations that would allow for the lowest rate of heat transfer. Using an infrared camera and ThermaGRAM imaging software, the temperature was calculated and used to estimate the degree of heat transfer.
  
  
  RESULTS
  Codman ISOCOOL forceps powered the Ellman Surgitron generator showed the greatest dissipation (at mid-power, the luminance decreased from 250 units to 80 units within 60 seconds) and the least production of heat after activation. Codman ISOCOOL forceps powered by the Codman SYNERGY MALIS generator showed less heat dissipation (at mid-power, the luminance decreased from 250 units to 195 units within 60 seconds) than the Ellman forceps and Ellman Surgitron generator combination (at mid-power, the luminance decreased from 250 units to 125 units within 60 seconds).
  
  
  CONCLUSIONS
  These data suggest that the incorporation of the Ellman Surgitron Generator can result in the reduction of thermal transfer with conventional bipolar forceps compared with other generators. The combination with Codman ISOCOOL forceps can maximize the potential safety associated with bipolar coagulation. With regard to the use of comarketed pairs of forceps and generators, the combination of Ellman Surgitron Generator and Ellman bipolar forceps provided the best thermal profile.
authors.affiliation: Division of Pediatric Neurosurgery, Children's Hospital of San Diego, San Diego, California, USA; Department of Neurosurgery, University of California San Diego School of Medicine, San Diego, California, USA.
authors.forename: Sassan
authors.initials: S
authors.lastname: Keshavarzi
authors.affiliation: Division of Pediatric Neurosurgery, Children's Hospital of San Diego, San Diego, California, USA.
authors.forename: Armon
authors.initials: A
authors.lastname: Bolour
authors.affiliation: Department of Neurological Surgery, Washington University School of Medicine, St. Louis, Missouri, USA.
authors.forename: Chester
authors.initials: C
authors.lastname: Yarbrough
authors.affiliation: Division of Pediatric Neurosurgery, Children's Hospital of San Diego, San Diego, California, USA.
authors.forename: Karen
authors.initials: K
authors.lastname: Mendez
authors.affiliation: Division of Pediatric Neurosurgery, Children's Hospital of San Diego, San Diego, California, USA.
authors.forename: Behzad
authors.initials: B
authors.lastname: Behrouzi
authors.affiliation: Department of Neuroscience, University of Arizona, Tucson, Arizona, USA.
authors.forename: Aimen S
authors.initials: AS
authors.lastname: Kasasbeh
authors.affiliation: Division of Pediatric Neurosurgery, Children's Hospital of San Diego, San Diego, California, USA; Department of Neurosurgery, University of California San Diego School of Medicine, San Diego, California, USA. Electronic address: mlevy@chsd.org.
authors.forename: Michael L
authors.initials: ML
authors.lastname: Levy
mesh_terms: D004564:Electrocoagulation / Q000295:instrumentation* / Q000379:methods; D006489:Hemostatic Techniques / Q000295:instrumentation*; D007259:Infrared Rays; D059906:Neuroimaging; D019635:Neurosurgical Procedures / Q000295:instrumentation* / Q000379:methods; D012984:Software; D013525:Surgical Instruments; D013696:Temperature; D013814:Thermal Conductivity; D013816:Thermodynamics
keywords: Bipolar electrocoagulation; Coagulation; Infrared imaging; Surgical techniques; Thermal imaging