Vascularity evaluation of the equine tarsocrural and proximal intertarsal joint septum, and comparative analysis of two arthroscopic transection techniques.

OBJECTIVE: To evaluate vascularity of the synovial membrane covered septum (SMS) separating the tarsocrural (TC) and proximal intertarsal (PIT) joints (Part 1) and compare two methods of transection, electrosurgical or Ferris Smith rongeur (FS rongeur) (Part 2). STUDY DESIGN: Experimental study. SAMPLE POPULATION: Part 1, 10 SMS (n = 5 horses). Part 2, six horses (n = 12 tarsi). METHODS: In part 1, SMS harvested postmortem were each divided into eight regions of interest (ROIs), processed for histology, and immunostained with anti-α-actin antibody for blood vessel identification. Vascular density was calculated for each ROI. Data was compared within and between horses. In part 2, six horses underwent TC arthroscopy. Each limb was randomly assigned to undergo either electrosurgical or FS rongeur SMS transection. SMS transection and total operative time were recorded. Intraoperative hemorrhage was scored. Data was compared between both techniques. RESULTS: Significant interindividual variations in SMS vascular density were detected (p = .02), but there were no differences among ROIs. No differences in the transection time were detected between electrosurgery (4.83 ± 0.54 min) and FS rongeur (4.33 ± 0.67 min). No differences were found in intraoperative hemorrhage scores between techniques. CONCLUSION: Vascularity within the SMS varies among horses but not within its regions. Electrosurgical or FS rongeur transection of the medial SMS during tarsocrural arthroscopy is a rapid technique and improves surgical access to the dorsal compartment of the PIT.

Complications of canine tonsillectomy by clamping technique combined with monopolar electrosurgery - a retrospective study of 39 cases.

BACKGROUND: Canine tonsillectomy is performed due to acute or chronic tonsillitis, neoplasia, trauma or occasionally brachycephalic obstructive airway syndrome. Several tonsillectomy techniques are used but information about surgical complications is scarce. This retrospective study of patient records at the University Animal Hospital aimed to investigate complications related to canine tonsillectomy performed by 20-min clamping combined with monopolar electrosurgery. Inclusion criteria were bilateral tonsillectomy performed with "20-min clamping technique combined with monopolar electrosurgery without suture or ligation". Exclusion criteria were unilateral tonsillectomy, tonsillar neoplasia, additional surgical procedures other than tonsillectomy, cases where sutures were used initially, and cases where unspecified or other methods of tonsillectomy were used. The search of the patient records of the University Animal Hospital included a 10-year period. Complications that required additional anaesthesia were defined as major complications. Minor complications were handled during surgery or after surgery without surgical intervention. RESULTS: Of 39 dogs that fulfilled the inclusion criteria, 11 dogs had complications and out of those 1 dog had two complications. Altogether, of the 12 complications, 2 were classified as major complications and 10 as minor. The most frequent complication was bleeding from the surgical site, in total 11 incidences; 10 dogs had an incidence of bleeding and out of those, 1 dog bled twice, both during and after surgery. Of these 10 dogs that bled, seven incidences of bleeding occurred during surgery and four incidences occurred after surgery. The two dogs with major complications were re-anaesthetized due to bleeding after surgery. No lethal complications occurred and all dogs survived to discharge. CONCLUSIONS: Bleeding during and after surgery was a common complication in dogs after bilateral tonsillectomy using "20-min clamping technique combined with monopolar electrocautery". Revision intervention was often needed, sometimes urgently. Although no comparison was made with another technique, the studied technique should be used with caution.

Experimental assessment of three electrosurgical tissue-sealing devices in a porcine model.

Three electrosurgical tissue-sealing devices (EnSeal ETSDRC-01, LigaSure LS1500 and Thunderbeat TB-0535PC) were compared regarding sealing time (ST), maximum working temperature (WTmax) and the total (MTZtotal) as well as the collateral microscopic thermal injury zone (MTZcollat) using laparoscopic handpieces 5 mm in diameter on four types of tissue (liver, mesentery, cross striated muscle and spleen) in an in vivo porcine model. LigaSure had the lowest mean ST in spleen, mesentery, muscle and liver, followed by Thunderbeat and EnSeal with significant differences between all types of tissues and devices. The significantly lowest mean WTmax was obtained for EnSeal in mesentery, muscle and liver. LigaSure and EnSeal operated at the lowest temperature in spleen without a significant difference between them. Thunderbeat produced significantly higher temperature peaks in all cases. The lowest mean MTZtotal was caused by LigaSure and EnSeal in spleen, mesentery and muscle without significant differences between them, followed by the significantly higher values of Thunderbeat. Nevertheless, Thunderbeat produced the significantly lowest mean MTZtotal in the liver. EnSeal produced the lowest mean MTZcollat in the liver, followed by LigaSure and Thunderbeat showing significant differences. EnSeal and LigaSure produced the lowest mean MTZcollat in the spleen, mesentery and muscle without significant differences between them, followed by the significantly higher values of Thunderbeat. Based on the results of this study, Thunderbeat seems to be more invasive to tissue integrity (even without the activation of the ultrasonic scissor function) than EnSeal or LigaSure, that operate at lower temperatures and were found to cause negligible collateral thermal damage.

Vasectomy in Mouse Model Using Electrosurgery Machine.

Vasectomy in laboratory animals is a crucial step in the production of surrogate female mice. The surrogate mothers play a key role in successful embryo transfer, most important steps for the production of transgenic animal models, investigation of the preimplantation embryo development, and revitalization of cryopreserved strains. Abdominal and scrotal surgeries are common surgical procedures used in routine veterinary practice to produce vasectomized males. Two different surgical practice, namely electrosurgery and cold surgical practice, have been used as common techniques in operating rooms. Based on current knowledge, there is no published “technical note” as a detailed and step by step guideline to describe vasectomy using an electrosurgery machine (i.e., Bovie machine) in laboratory animal research and breeding facilities.The common problem during the laboratory animal surgery would be animal mortalities as a consequence of profound bleeding. The use of Bovie machine leads to the prevention of profound bleeding during the surgical practice.

Adaptation and evaluation of a monopolar electrosurgical triangle-tip knife for transendoscopic ventriculocordectomy in healthy horses.

OBJECTIVE: To evaluate the efficacy and safety of a transendoscopic monopolar electrosurgical triangle-tip knife as instrumentation to perform unilateral ventriculocordectomy (VC) in healthy adult horses. STUDY DESIGN: In vivo experimental study. STUDY POPULATION: Nine horses donated for medical conditions unrelated to respiratory system. METHODS: The triangle-tip knife was applied in contact fashion. Left VC was performed under standing sedation. Endoscopic images of the upper airway were graded for inflammation by 2 masked surgeons preoperatively and immediately, 24 hours and, in 2 cases, 7 and 14 days postoperatively. Four larynxes were examined for histological evidence of inflammation and collagen deposition at 24 hours (n = 2) and at 14 days (n = 2) after surgery. RESULTS: Ventriculocordectomy was successfully performed in all horses. Endoscopic evidence of inflammation was scored as normal (preoperatively), mild (immediately postoperatively), mild (24 hours postoperatively), mild (7 days postoperatively), and normal (14 days postoperatively). According to histopathology, inflammation of the surgical site and ventricularis muscle was generally increased (variable is common and is present in most high-power fields) 24 hours and 14 days postoperatively. Fibrosis and collagen deposition also seemed increased at the surgical site 14 days postoperatively. CONCLUSION: Ventriculocordectomy was successfully performed with an electrosurgical triangle-tip knife and resulted in acceptable short-term outcomes. CLINICAL SIGNIFICANCE: The use of an electrosurgical triangle-tip knife alternative instrumentation may be offer an alternative option to perform VC in practices when diode laser is not available or is cost prohibitive. Longer term evaluation of the VC site is required to determine the effect on rima glottic cross-sectional area.

Plasma-Mediated Bipolar Radiofrequency Ablation of Overlong Soft Palate in the Dog: A Pilot Study.

The objective of this study was to compare the clinical, biological, macroscopic, and histologic outcomes after resection of the soft palate by plasma-mediated bipolar radiofrequency ablation (PBRA) or traditional incisional techniques (incisional soft palate resection [INC]) in dogs. Ten dogs were divided in two groups. In the INC group, the soft palate was incised with scissors and the wound was sutured in a continuous pattern. In the PBRA group, a wand was used to ablate the desired portion of the soft palate, without suture. Clinical, biological, macroscopic, and histologic assessments were scheduled over 14 days. The duration of surgery was significantly shorter for the PBRA group. The C-reactive protein concentrations were significantly higher in the PBRA group at 6 hr and on day 3 (P < .05) but with values very close to the baseline. C-reactive protein concentrations were maximal, but with low values (<25 mg/L), at day 1 for both techniques. The irregularity scores for the soft palate caudal border on days 1, 3, and 14 were significantly higher in the INC group than in the PBRA group (P < .05). The main histopathologic changes were the presence of superficial granulomas and a significantly greater depth of tissue damage in the INC group (2.5 ± 0.3 mm) compared with the PBRA group (1.5 ± 0.1 mm; P < .05). PBRA compared favorably with the traditional technique in terms of ease, duration of surgery, and depth of tissue damage. Future studies are warranted to validate its effectiveness for treating brachycephalic airway obstruction syndrome in dogs.

Healing of canine skin incisions made with monopolar electrosurgery versus scalpel blade.

OBJECTIVE: To determine the influence of monopolar electrosurgery in cutting mode set at 10, 20, or 30 W on surgery time, hemostasis, and healing of cutaneous wounds compared to scalpel incisions. STUDY DESIGN: Randomized blinded control trial. ANIMALS: Dogs (n = 15). METHODS: Four skin incisions were created on either side of the dorsal midline with a scalpel, or monopolar electrosurgery at 10, 20, and 30 W. Surgical time and incisional bleeding were measured. Each incision was assessed daily for edema, erythema and discharge, and complications. Healing was evaluated via histology at 7 days. Results were analyzed for significance at P ≤ .05. RESULTS: Surgical time and hemostasis were improved in all electrosurgery groups. Erythema was reduced in all electrosurgical incisions for days 1-4, but was greater in wounds created via electrosurgery at 20 W than those made with a scalpel blade by day 7. No difference was noted in the degree of edema or presence of wound discharge. All histologic variables of tissue healing were lower in electrosurgical incisions than scalpel incisions (P < .001). Ten incisional complications occurred, all associated with electrosurgery. CONCLUSIONS: The use of monopolar electrosurgery at 10, 20, and 30 W in a cutting waveform improved hemostasis and surgical time when incising canine skin, but delayed healing and increased complications within the first 7 days compared to scalpel incisions.

Carotid artery bursting pressure and seal time after multiple uses of a vessel sealing device.

OBJECTIVE: To determine any loss of function of a single-use bipolar vessel sealing device after repeated sterilization and use on canine carotid arteries. STUDY DESIGN: Ex vivo; randomized block design (dog). SAMPLE POPULATION: Carotid artery segments (n = 90) from 15 canine cadavers. METHODS: Six 10-mm LigaSure Atlas 20 cm devices (Covidien Inc, Minneapolis, Minnesota) were used to seal canine carotid artery segments in one cadaver, then resterilized using ethylene oxide and reused in a second cadaver, and so on, for a total of 15 uses/15 cadavers per LigaSure. Sealing times and bursting pressures of each carotid artery segment after each use were recorded. Charring and sticking at each seal location was qualitatively assessed. RESULTS: Mean (SD) sealing time for all segments was 5.3 (1.4) seconds, ranging from 2.7 to 9.5 seconds. There was no significant change in sealing time for successive uses (P = .117). The mean (SD) bursting pressure for all segments was 1041.3 (316.7) mm Hg, ranging from 355 to 1555 mm Hg. There was no change in bursting pressure across uses (P = .57). Moderate sticking and charring occurred at each time point but was not subjectively different throughout the study. CONCLUSION: The LigaSure Atlas vessel sealing device can be used and resterilized with ethylene oxide up to 15 times with no change in sealing time or bursting pressure of the seal.

Laparoscopic cryptorchidectomy with a vessel-sealing device in dorsal recumbent horses: 43 cases.

OBJECTIVE: To document laparoscopic cryptorchidectomy with a vessel-sealing device in dorsal recumbent horses. STUDY DESIGN: Retrospective study. ANIMALS: Forty-three male horses. METHODS: Food was withheld for 36 hours before horses were placed under general anesthesia and positioned in dorsal recumbency. One laparoscopic portal and 2 instrument portals were placed for the laparoscopic procedure. A third instrument portal was created in bilateral cryptorchid horses. A vessel-sealing device was used for hemostasis and transection of retained testes. Descended testes were removed via closed castration with primary closure of the scrotal incision. Time required for removal of the retained testis and perioperative complications were recorded. Short-term (14, 30, 60 days) and long-term follow-up (>1.5 years) consisted of telephone interview with owners and referring veterinarians. RESULTS: Forty-three male horses underwent laparoscopic cryptorchidectomy. Thirteen horses were bilateral cryptorchids, 19 were unilateral cryptorchids with a descended testis, and 11 were unilateral cryptorchids with 1 testis previously removed. Inguinal testes, identified in 5 horses, were pulled into the abdomen prior to excision. The vaginal ring was apposed with endoscopic staples in 3 of 5 horses. Mean surgery time was 31.34 ± 7.41 minutes. No intraoperative or immediate postoperative complications were encountered. No short-term or long-term complications were reported. CONCLUSION: Laparoscopic cryptorchidectomy can be safely performed with a vessel sealing-device in dorsal recumbent horses. This method was effective and did not result in any complication in our case series.

Electrosurgery reduces blood loss and immediate postoperative inflammation compared to cold instruments for midline celiotomy in dogs: A randomized controlled trial.

OBJECTIVES: To compare the use of an electrosurgical device with traditional cold instruments (scalpel and scissors) for midline celiotomy incision. STUDY DESIGN: Prospective randomized controlled clinical trial. SAMPLE POPULATION: One hundred and twenty client-owned dogs undergoing abdominal surgery. METHODS: Dogs were prospectively recruited and randomized to receive electroincision or cold instrument incision. For cold incision, surgeons used basic surgical instruments including scalpel and scissors. For electroincision, surgeons only used the electrosurgical device in cutting mode. Time for the approach, blood loss, and the incision length were recorded. A blinded observer assessed pain and incision redness, swelling, and discharge at 24 and 48 hours postoperative (graded 0-3). Owner assessment of incision healing was recorded by telephone interview. RESULTS: Blood loss during surgery was significantly lower for electroincision (mean 0.7, SD 1.7 mL) than cold incision (mean 3.0, SD 4.3 mL, P < .0001) with no significant difference in incision length or time for approach. Electroincision was associated with significantly less incision redness (cold median 1, range 0-3; electroincision median 0, range 0-2, P = .02) and less incision discharge (cold median 0.5 range 0-3; electroincision median 0, range 0-1, P = .006) at 24 hours postoperative. There was no significant difference in pain scores or incision healing in dogs receiving the two techniques. No incisional hernias were reported. A surgical site infection occurred in 1 dog (cold incision). CONCLUSIONS: Electroincision for a celiotomy approach in the dog reduces blood loss, and incision redness and discharge in the immediate postoperative period without affecting the occurrence of wound complications such as infection and dehiscence (including linea alba).

Radiofrequency Probe and Sharp Transection for Tenoscopic-Guided Desmotomy of the Accessory Ligament of the Superficial Digital Flexor Tendon.

OBJECTIVE: To compare intra and postoperative clinical features of desmotomy of the accessory ligament of the superficial digital flexor tendon (ALSDFT) using the Saber radiofrequency (SaberRF) electrosurgical probe versus sharp transection with a tenotomy knife. STUDY DESIGN: Randomized, controlled, blocked (horse) design. ANIMALS: Adult horses (n = 6). METHODS: Each horse received bilateral, tenoscopic-guided ALSDFT desmotomy with a SaberRF and tenotomy knife, randomly assigned to left, or right limb. The desmotomy duration and intraoperative hemorrhage grades were recorded. Postoperatively, the grades for surgical incision, carpal sheath effusion, carpal range of motion, flexion pain, and lameness were recorded. Light microscopy using hematoxylin and eosin, and viability staining were performed on the ALSDFT, flexor carpi radialis tendon, radial head of the deep digital flexor tendon, and the deep digital flexor tendon. Variables were compared between desmotomy methods with a paired t-test, Wilcoxon signed rank test, or a repeated measures mixed model. Statistical significance was set at P < .05. RESULTS: Desmotomy of the ALSDFT was completed in all horses. Only mild hemorrhage was observed and not different between methods (SaberRF 2/5 limbs; tenotomy knife 5/6 limbs, P = .078). Carpal sheath effusion was greater for SaberRF at Day 1 (P = .019) but not different from tenotomy knife at any later time. There was no significant difference between methods for viability staining or other measured outcomes. CONCLUSIONS: Tenoscopic-guided ALSDFT desmotomy with the SaberRF probe showed no difference in measured outcomes to sharp transection with a tenotomy knife and minimal collateral tissue damage was observed.

Laparoscopic cryptorchidectomy and ovariectomy in standing horses using the EnSeal® tissue-sealing device.

In the present series of cases, 8 laparoscopic cryptorchidectomies and 4 laparoscopic ovariectomies were carried out in sedated standing horses. Sedation involved a lesser anaesthesiological risk than does general anaesthesia. As compared to laparotomic exposure, the minimally invasive laparoscopic intervention provided better visualisation, shorter operative time and faster recovery. The blood vessels supplying the testes and ovaries and the suspensory ligaments of the organs were sealed and cut with EnSeal®, an adaptive bipolar electrosurgical blood vessel- and tissue-sealing device. The clinical use of the blood vessel- and tissue-sealing device proved to be successful in all cases. Gradual separation of the intact tissue from the treated, compacted, dehydrated and homogenised tissue areas and occlusion of the lumen of blood vessels treated with the device could be observed in all histological sections. To the best of our knowledge, this is the first report on the use of EnSeal® for laparoscopic cryptorchidectomy and ovariectomy in horses.

An alternative pathway electrosurgical unit injury in a dog.

OBJECTIVE: To report esophageal perforation, caused by alternative current pathway from the use of a monopolar electrosurgery unit (ESU), during routine orthopedic surgery in a dog. STUDY DESIGN: Clinical report. ANIMALS: Two-year-old male Labrador retriever. METHODS: Medial meniscectomy and lateral suture stabilization were performed on a healthy Labrador retriever with a ruptured cranial cruciate ligament. Monopolar electrosurgery was used during the procedure for hemostasis and tissue dissection. Anesthetic monitoring was augmented with an esophageal electrocardiogram (ECG) probe. The day after surgery, the dog appeared dehydrated. After intravenous fluid therapy, respiratory distress was noted and thoracic radiography and contrast fluoroscopy revealed an esophageal perforation. RESULTS: Exploratory surgery was planned to repair the defect. Cardiac arrest occurred after induction. Gross necropsy findings and histopathologic examination revealed lesions consistent with thermal necrosis of the esophagus and myocardial degeneration. An internal investigation of this medical device accident revealed that multiple factors may have contributed to the injury. CONCLUSIONS: An alternative current pathway from the monopolar ESU to the esophageal ECG probe resulted in a full-thickness esophageal thermal injury and cardiac failure.

Electrosurgical tenoscopic desmotomy of the accessory ligament of the superficial digital flexor muscle (proximal check ligament) in horses.

OBJECTIVE: To report a tenoscopic technique using monopolar electrosurgery to transect the accessory ligament of superficial digital flexor muscle (AL-SDFM) and outcome in 33 horses. STUDY DESIGN: Case series. ANIMALS: Horses (n=33). METHODS: Medical files and surgery video recordings of horses that had AL-SDFM desmotomy performed by tenoscopy with monopolar electrosurgical electrodes were reviewed. RESULTS: Of 33 horses, 24 were Standardbred racehorses with surgery performed bilaterally for superficial digital flexor tendonitis and 9 horses had flexural deformity. Severe (n=6) and mild (6) intrathecal hemorrhage was the most common intraoperative complication. Large intrathecal vessels including the nutrient artery were successfully electrocoagulated and AL-SDFM transection was completed. Clear/serosanguinous drainage from skin incisions was observed for 4.3±3.3 days (mean, SD). Protracted wound drainage for >4 days occurred in 10 horses, principally in the group treated for flexural deformities (P=.01). CONCLUSIONS: Sixty-four AL-SDFM were transected under tenoscopic observation using monopolar electrodes. Electrocoagulation of large intrathecal vessels, including the nutrient artery, was possible in all cases and allowed completion of desmotomy. Postoperative wound care was similar to routine tenoscopy in most (70%) horses. Aseptic protracted wound drainage was observed in 30% of horses (principally those with flexural deformity), and led to a prolonged hospitalization.

Electromagnetic energy sources in surgery.

The biophysics, mechanism of actions, applications, benefits and complications of electromagnetic (EM) energy-based surgical instruments, and their current use are reviewed. Understanding the mechanism of action, tissue effects, and appropriate applications of EM devices is critical to achieving an optimal surgical outcome. Although a more diverse range of EM devices are used in human medicine, current use in veterinary medicine is limited to conventional electrosurgery and CO(2) lasers.

Use of an electrothermal, feedback-controlled, bipolar sealing device for resection of the elongated portion of the soft palate in dogs with obstructive upper airway disease.

OBJECTIVE: To evaluate efficacy and safety of using an electrothermal, feedback-controlled, bipolar sealing device (BSD) for resection of the elongated portion of the soft palate in brachycephalic dogs with upper airway obstruction. DESIGN: Uncontrolled clinical trial. ANIMALS: 24 brachycephalic dogs with airway obstruction and elongated soft palate. PROCEDURES: In all dogs, the excess portion of the soft palate was resected with a BSD. A score for severity of clinical signs of respiratory tract obstruction was assigned before surgery, during the first 24 hours after surgery, and at the time of final follow-up 12 to 23 months after surgery. Potential scores ranged from 0 (no clinical signs even with moderate to vigorous activity) to 4 (agonal breathing or severe cyanosis). RESULTS: None of the dogs died or developed life-threatening complications after surgery. Clinical scores after surgery (mean +/- SD, 0.3 +/- 0.6) and at the time of final follow-up (0.9 + 0.5) were significantly lower than preoperative scores (2.6 +/- 0.8). CONCLUSIONS AND CLINICAL RELEVANCE: Results indicated that a BSD can be safely used for resection of the elongated portion of the soft palate in brachycephalic dogs with upper airway obstruction.

Electrosurgery as the sole means of haemostasis during the laparoscopic removal of pathologically enlarged ovaries in mares: a report of 55 cases.

REASONS FOR PERFORMING STUDY: There is little published clinical evidence on the use of a laparoscopic approach for the removal of pathologically enlarged ovaries in standing mares. OBJECTIVES: To show the orders of success and complication rates that can be expected if pathologically enlarged ovaries are removed from standing, sedated mares under laparoscopic guidance using only electrosurgical means of haemostasis. METHODS: A retrospective analysis was made of 55 mares in which the removal of an enlarged ovary was attempted by applying a standard laparoscopic procedure for routine ovariectomy in standing mares including a reliance solely on one of 2 types of electrosurgical bipolar forceps with an integrated guillotine for haemostasis and transection of the ovarian pedicle. The outcomes and complications encountered were recorded. Logistic regression analysis was performed to identify the risk of any complications associated with the size of the ovary removed and the instrument used. RESULTS: In 54 of the 55 mares, the surgery was successfully accomplished by the planned approach. In one mare there was significant intraoperative haemorrhage and this necessitated the additional use of a prosthetic haemostatic device. The only other complications encountered were post operative abdominal discomfort (n = 9), delayed incisional wound healing (n = 6) and iatrogenic uterine puncture (n = 2). One mare developed a rectal tear, but not as a direct complication of the surgical procedure. None of these prevented a long-term successful outcome. CONCLUSIONS: The removal of pathologically enlarged ovaries (up to 30 cm diameter) from mares under standing sedation can be accomplished predictably and safely by applying the standard laparoscopic approach that is established for routine laparoscopic ovariectomy, including a reliance solely on endoscopic electrosurgery instruments for haemostasis of the ovarian pedicle. POTENTIAL RELEVANCE: This study shows that the simple standing laparoscopic technique now favoured for routine ovariectomy can be used safely and reliably for the removal of pathologically enlarged ovaries. This promises to be of significant clinical advantage to mares so affected.

Histologic comparison of canine skin biopsies collected using monopolar electrosurgery, CO2 laser, radiowave radiosurgery, skin biopsy punch, and scalpel.

OBJECTIVE: To compare the histologic appearance of canine skin biopsies collected by use of a scalpel, skin biopsy punch, monopolar electrosurgery, CO2 laser, and radio wave radiosurgery in fully rectified wave form (RWRS). STUDY DESIGN: Experimental, randomized design. ANIMALS: Healthy adult grayhounds (n=4). METHODS: Skin biopsies were collected using 5 techniques. Cut margins of biopsy specimens and adjacent peripheral skin were evaluated using light microscopy to compare penetration of the dermis by tissue carbonization (char). RESULTS: No char occurred in skin specimens collected by biopsy punch and scalpel. Char penetration occurred in all specimens collected by electrosurgery, CO2 laser, and RWRS. Mean char penetration in skin biopsies collected by RWRS (0.158 mm) was significantly less than for monopolar electrosurgery (0.223 mm) and CO2 laser (0.215 mm). Mean char penetration in adjacent peripheral skin surrounding biopsies collected by RWRS (0.171 mm) was significantly less than monopolar electrosurgery (0.255 mm) but not less than CO2 laser (0.215 mm, P<.07). CONCLUSIONS: RWRS (blended waves in cut-coagulate mode) caused less lateral thermal damage to canine skin biopsies than monopolar electrosurgery and CO2 laser and less lateral thermal injury to peripheral skin than monopolar electrosurgery. CLINICAL RELEVANCE: Excision of canine skin biopsies with heat-generating devices may not allow reliable histologic interpretation, particularly when assessing margins of small biopsy specimens. RWRS may be less traumatic to canine skin than monopolar electrosurgery and CO2 laser when used to make incisions.

A histopathological comparison of two techniques for soft palate resection in normal dogs.

Eighteen dogs were used to compare histopathological findings following excision of the soft palate using either a bipolar sealing device or a carbon dioxide laser. Histopathological comparisons were done at 48 and 96 hours after soft palate resection. Mean depths of tissue injury at 96 hours were 3.5 and 3.33 mm for bipolar sealing device and carbon dioxide laser, respectively. Control of hemorrhage was excellent in all dogs, and none of the dogs developed signs of respiratory compromise after soft palate resection. Using the bipolar sealing device for soft palate resection was significantly faster than using the carbon dioxide laser, although both techniques were fast.

The use of radiofrequency energy during arthroscopic surgery and its effects on intraarticular tissues.

The use of radiofrequency (RF) energy has become very popular in human and veterinary arthroscopic surgery since the late 1990s. Both monopolar and bipolar RF units are available. Application of RF energy to joint capsular tissue leads to immediate tissue shrinkage that is both power and temperature dependent. Changes in joint capsular tissue have been noted at temperatures greater than 65 degrees C. Treatment of articular cartilage with RF energy leads to immediate chondrocyte damage. This damage is also power and temperature dependent and is observed at temperatures as low as 45 degrees C. Caution should be used when applying RF energy within a joint to prevent or minimize articular cartilage injury.