title: Heat injury to the inferior vena cava by bipolar tissue sealer.
abstract: BACKGROUND
  Although energy devices have brought big advantages to surgery, there are few reports about disadvantages. We conducted an animal experiment to clarify the thermal effect of the bipolar tissue sealing system, Enseal™, to adjacent vessels of the inferior vena cava.
  
  
  METHODS
  We used an experimental miniature pig for the experiment. After laparotomy and mobilization of the intestine, the inferior vena cava was exposed. We activated the device under two different conditions: In the first group, the so-called contact group (Group C), the blade of Enseal™ touched the surface of the IVC directly. In the other group, referred to as non-contact group (Group N), the blade was held about 1 mm away from the IVC. Activation time of the generator was 5, 10, and 15 s, respectively, in both groups.
  
  
  RESULTS
  In Group C, the mean IVC surface temperature was 47.2, 57.6, and 60.4 °C for 5, 10, and 15 s, respectively. The difference between the mean temperature of 5 and 15 s is statistically significant. In Group N, no statistical significance was achieved in all time-settings. The muscular layers of the IVC wall in Group C after 10 s of activation were broken, and cell nuclei were shrunken.
  
  
  CONCLUSIONS
  When Enseal™ is used, contact with the adjacent vessels of the IVC should be avoided at all. It could increase the risk of heat injury to the vessel wall.
authors.affiliation: Department of Gastroenterological Surgery, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto, 860-0811, Japan. chika@kumamoto-u.ac.jp.
authors.forename: Akira
authors.initials: A
authors.lastname: Chikamoto
authors.affiliation: Department of Gastroenterological Surgery, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto, 860-0811, Japan.
authors.forename: Takayoshi
authors.initials: T
authors.lastname: Kaida
authors.affiliation: Department of Gastroenterological Surgery, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto, 860-0811, Japan.
authors.forename: Kota
authors.initials: K
authors.lastname: Arima
authors.affiliation: Department of Gastroenterological Surgery, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto, 860-0811, Japan.
authors.forename: Takaaki
authors.initials: T
authors.lastname: Higashi
authors.affiliation: Department of Gastroenterological Surgery, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto, 860-0811, Japan.
authors.forename: Katsunobu
authors.initials: K
authors.lastname: Taki
authors.affiliation: Gastroenterology Center, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Ida
authors.affiliation: Department of Gastroenterological Surgery, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto, 860-0811, Japan.
authors.forename: Hirohisa
authors.initials: H
authors.lastname: Okabe
authors.affiliation: Department of Gastroenterological Surgery, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto, 860-0811, Japan.
authors.forename: Hidetoshi
authors.initials: H
authors.lastname: Nitta
authors.affiliation: Department of Gastroenterological Surgery, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto, 860-0811, Japan.
authors.forename: Hiromitsu
authors.initials: H
authors.lastname: Hayashi
authors.affiliation: Department of Gastroenterological Surgery, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto, 860-0811, Japan.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Hashimoto
authors.affiliation: Gastroenterology Center, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan.
authors.forename: Masayuki
authors.initials: M
authors.lastname: Watanabe
authors.affiliation: Department of Gastroenterological Surgery, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto, 860-0811, Japan.
authors.forename: Toru
authors.initials: T
authors.lastname: Beppu
authors.affiliation: Department of Gastroenterological Surgery, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto, 860-0811, Japan.
authors.forename: Hideo
authors.initials: H
authors.lastname: Baba
mesh_terms: D000818:Animals; D003972:Diathermy / Q000295:instrumentation*; D006358:Hot Temperature / Q000009:adverse effects*; D023421:Models, Animal; D013552:Swine; D014682:Vena Cava, Inferior / Q000293:injuries*
keywords: Bipolar tissue sealer; Heat injury; Instruments; Technical