Studies on coagulation and the development of an automatic computerized bipolar coagulator. Technical note.

ABSTRACT

A new computerized bipolar coagulator is described in which tissue heating is switched off automatically when adequate vessel occlusion has been achieved, thus preventing overheating, undue tissue damage, cutting, and sticking of the forceps. Experiments with radiofrequency (rf) heating of albumin or arteries revealed an impedance minimum at the moment of coagulation. The attainment of this impedance minimum is transmitted electronically via a microprocessor to the coagulator, which automatically shuts off the rf energy supply. In experiments, adequate artery strength and avoidance of the drawbacks of conventional coagulation methods were achieved when rf heating was shut off soon after the impedance minimum was reached. Neither irrigation for cooling nor cleaning of the forceps tips was necessary. Electronic feedback through the same cables as used for coagulation enabled the use of conventional bipolar cables and forceps. The bipolar coagulator described can also be used for conventional bipolar coagulation under visual control. The microcomputer enables 1) automatic coagulation cycles that start when tissue is picked up in the forceps and stop automatically on completion of the seal; 2) the change of power setting from a pedal and activation of automatic cycles by the pedal as described above or surgeon-controlled coagulation, which facilitates the use of alternative debridement with inactive forceps; 3) cable testing; and 4) negligible disturbance of the intraoperative monitoring equipment.