Comparison of ferromagnetic induction and bipolar electrosurgery and suction in corticotomies in pig cerebrum.
BACKGROUND
The effects of newer energy-based surgical dissection and coagulation modalities on cerebral tissue have not been investigated. Several instruments have been developed to address the limitations of traditional electrosurgical instruments in the nervous system. We compared the effects of standard bipolar electrocautery and suction (BPS) with those of a new ferromagnetic induction (FMI) device in corticotomies of pig cerebral tissue as assessed by magnetic resonance imaging (MRI) and histological analysis.


METHODS
Three adult pigs underwent bilateral corticotomies (3 cm long×1 cm deep) using both FMI and BPS. The acute cerebral tissue edema created by each method was measured on coronal volumetric T2-weighted MRI sequences immediately after surgery. A lateral thermal "damage index" was calculated by dividing the width of the visible T2 tissue edema by the measured depth. The radiographic damage indices with each method were compared statistically. Histological analysis of each incision was conducted to compare the extent of tissue damage.


RESULTS
MRI showed that the mean radiographic damage index of each corticotomy was significantly lower with the FMI (0.30 ± 0.02 (0.28-0.32)) than with the BPS method (0.54 ± 0.11 (0.42-0.64)) (p = 0.02). Histological analysis suggested a correlation with the radiographic findings as the FMI tissue samples demonstrated less adjacent tissue damage than BPS.


CONCLUSIONS
FMI appeared to cause less adjacent tissue damage than the BPS method in pig cerebral tissue based on quantitative radiographic and qualitative histological analysis. Future studies are needed to investigate the clinical implications of energy-based surgical dissection on cerebral tissue.
Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, Salt Lake City, UT, USA.
Christian A
CA
Bowers
Department of Research and Pathology, Office of Comparative Medicine, University of Utah, Salt Lake City, UT, USA.
Greg
G
Burns
Department of Radiology, Clinical Neurosciences Center, University of Utah, Salt Lake City, UT, USA.
Karen
K
Salzman
ARUP and Department of Veterinary Pathology, University of Utah, Salt Lake City, UT, USA.
Lawrence
L
McGill
Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, Salt Lake City, UT, USA. Electronic address: neuropub@hsc.utah.edu.
Joel D
JD
MacDonald
D000818:Animals; D054022:Cerebrum / Q000601:surgery*; D004210:Dissection / Q000295:instrumentation*; D004598:Electrosurgery / Q000295:instrumentation*; D008279:Magnetic Resonance Imaging; D059346:Magnets; D013396:Suction / Q000295:instrumentation; D013552:Swine
Bipolar electrocautery; Corticotomy; Electrosurgical device; Ferromagnetic induction loop