Вплив монополярного та біполярного методів резекції на відновні процеси в підшлунковій залозі

o. Yu. Usenko; K. G. Valikhnovska; I. M. Savytska; V. O. Kropelnytskyi

doi:10.26779/2522-1396.2018.12.55

o. Yu. Usenko Shupyk National Medical Academy of Postgraduate Education, Kyiv, Shalimov National Institute of Surgery and Transplantology, Kyiv http://orcid.org/0000-0003-4957-4104
K. G. Valikhnovska Shupyk National Medical Academy of Postgraduate Education, Kyiv https://orcid.org/0000-0001-8287-0736
I. M. Savytska Shalimov National Institute of Surgery and Transplantology, Kyiv https://orcid.org/0000-0002-2749-7825
V. O. Kropelnytskyi Shalimov National Institute of Surgery and Transplantology, Kyiv https://orcid.org/0000-0002-6390-6219

DOI: https://doi.org/10.26779/2522-1396.2018.12.55

Keywords: resection of pancreatic gland; coagulation necrosis; еlectrosurgery; bipolar welding; monopolar welding

Abstract

Objective. To compare the peculiarities of changes in the pancreatic gland tissue after conduction of experimental surgical interventions, using standard surgical technique as well as bipolar and monopolar welding.

Маterials and methods. Pancreatic resection was conducted on white laboratory rats in experimental conditions, using standard surgical technique, high-energy electrosurgical instrument in monopolar regime, and high-energy electrosurgical instrument in bipolar regime. Histological investigations were performed immediately after the operation and in 3, 7, 21 days, using light-optical microscope Leica DМ500.

Results. After application of standard surgical technique in early terms more significant inflammation have occurred and more rapidly a volume of a newly created connective tissue have been enhanced, than after application of electro-surgical methods in bipolar and monopolar regimes. After both kinds of electro-resection in a newly created tissue on the 7^th day the ducts have had formatted, what was not observed after application of standard technique. After resection, performed, using monopolar welding, lesser dense coagulation layer have had evolved, than after application of a bipolar method. In 21 days in the resection zone a more significant volume of connective tissue have been formatted and more significant inflammatory signs preserved, than after usage of a bipolar method.

Conclusion. Duration of the operative intervention is shortened, the bleeding occurrence risk is reduced, more hermetic conjunction on the resected surface is created, the restoration processes are not complicated while application of bipolar and monopolar technique of resection.

References

1. Morris ML, Tucker RD, Baron TH, Song LM. Electrosurgery in gastrointestinal endoscopy: principles to practice. Am J Gastroenterol. 2009 Jun;104(6):1563-74. doi: 10.1038/ajg.2009.105.

2. Linchevskyy O, Makarov A, Getman V. Lung sealing using the tissue-welding technology in spontaneous pneumothorax. Eur J Cardiothorac Surg. 2010 May;37(5):1126-8. doi: 10.1016/j.ejcts.2009.11.017.

3. Shapovalova YA. Criterions of efficacy of the soft tissues electric welding for the hemostasis guaranteeing in laparoscopic operations. Klin Khir.  2015;(8):17-20. [In Ukrainian].

4. You H, Yang Q. The advance of electrosurgery equipment. Zhongguo Yi Liao Qi Xie Za Zhi. 2012 Jul; 36(4):285-7. [In Chinese]

5. Alkatout I, Schollmeyer T, Hawaldar NA, Sharma N, Mettler L. Principles and safety measures of electrosurgery in laparoscopy. JSLS. 2012 Jan-Mar;16(1):130-9. doi: 10.4293/108680812X13291597716348.

6. Huschak G, Steen M, Kaisers UX. Principles and risks of electrosurgery. Anasthesiol Intensivmed Notfallmed Schmerzther. 2009 Jan;44(1):10-3. doi: 10.1055/s-0028-1128179. [In German].

7. Aird LN, Brown CJ. Systematic review and meta-analysis of electrocautery versus scalpel for surgical skin incisions. Am J Surg. 2012 Aug;204(2):216-21. doi: 10.1016/j.amjsurg.2011.09.032.