title: Cold-Plasma Coagulation on the Surface of the Small Bowel Is Safe in Pigs.
abstract: BACKGROUND
  Surgical treatment in patients with peritoneal carcinomatosis is often limited by the extent of small bowel involvement. We investigated the results of the application of cold-plasma coagulation on the surface of the small bowel.
  
  
  METHODS
  After permission by the federal government of Schleswig-Holstein, 8 female pigs underwent a laparoscopy and cold-plasma coagulation on the small bowel with different energy levels. Cold plasma is generated by high-frequency energy that is directed through helium gas. After 12 to 18 days a laparotomy was done and the abdomen was inspected for peritonitis, fistula, or other pathology.
  
  
  RESULTS
  Perioperative morbidity was low with transient diarrhea in 1 pig and loss of appetite for 1 day in another pig. We saw 1 interenteric fistula that was clinically not apparent after accidently prolonged application of cold-plasma coagulation (6 seconds instead of 2 seconds) with the highest energy level of 100 W. We did not observe any mortality. The depth of necrosis after application of different energy levels was dependent on the generator energy. We observed statistically significant differences between the different energy levels (20 W vs 10 W [P = .014], 75 W vs 50 W [P = .011]). The comparison of the necrosis depths after the application of 100 W and 75 W almost reached statistical significance (P = .059). We observed distinct interenteric adhesions as a result of the coagulation.
  
  
  CONCLUSIONS
  The application of cold-plasma coagulation on the surface of vital bowel in pigs is safe. We would recommend against the use of the highest energy level of 100 W before more clinical data are available.
authors.affiliation: University Clinic of Schleswig-Holstein, Campus Luebeck, Luebeck, Germany drmartinhoffmann@gmail.com.
authors.forename: Martin
authors.initials: M
authors.lastname: Hoffmann
authors.affiliation: University Clinic of Schleswig-Holstein, Campus Luebeck, Luebeck, Germany.
authors.forename: Anita
authors.initials: A
authors.lastname: Ulrich
authors.affiliation: University Clinic of Schleswig-Holstein, Campus Luebeck, Luebeck, Germany.
authors.forename: Jens Karsten
authors.initials: JK
authors.lastname: Habermann
authors.affiliation: University Clinic of Schleswig-Holstein, Campus Luebeck, Luebeck, Germany.
authors.forename: Ralf
authors.initials: R
authors.lastname: Bouchard
authors.affiliation: University Clinic of Schleswig-Holstein, Campus Luebeck, Luebeck, Germany.
authors.forename: Tilman
authors.initials: T
authors.lastname: Laubert
authors.affiliation: University Clinic of Schleswig-Holstein, Campus Luebeck, Luebeck, Germany.
authors.forename: Hans-Peter
authors.initials: HP
authors.lastname: Bruch
authors.affiliation: University Clinic of Schleswig-Holstein, Campus Luebeck, Luebeck, Germany.
authors.forename: Tobias
authors.initials: T
authors.lastname: Keck
authors.affiliation: WKK Heide, General and Thoracic Surgery, Heide, Germany.
authors.forename: Erik
authors.initials: E
authors.lastname: Schloericke
mesh_terms: D000818:Animals; D013505:Digestive System Surgical Procedures / Q000009:adverse effects* / Q000379:methods; D004564:Electrocoagulation / Q000009:adverse effects* / Q000379:methods; D005260:Female; D007421:Intestine, Small / Q000187:drug effects* / Q000293:injuries*; D058626:Plasma Gases / Q000009:adverse effects*; D013552:Swine; D000267:Tissue Adhesions
chemical_list: D058626:Plasma Gases
keywords: biomedical engineering; colorectal surgery; surgical oncology