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Yu H. The research on the effect of temperature of electro-surgical unit to surgical smoke distribution in theatre-in vitro and simulation study. PLoS One 2024; 19:e0299369. [PMID: 38457434 PMCID: PMC10923457 DOI: 10.1371/journal.pone.0299369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 02/08/2024] [Indexed: 03/10/2024] Open
Abstract
In electro-surgery, surgical smoke was hazard to surgeons and patient in theatre. In order to institute effective countermeasures, quantifying of the effect of tip temperature of electro-surgical unit to surgical smoke distribution in theatre was studied. The relation of tip temperature to power of electro-surgical unit through in vitro cutting experiment. Based on experiment data, the mathematical model was established to simulate the electro-surgery in laminar operation room. As the power of electro-surgical knife increased, the knife tip temperature increased. Total content of (CO, CO2, CH4, NH3) in waste gas and net flow rate of waste gas at outlet increased with the rising temperature of knife tip and formation rate of condensed tar droplets and non-viable particles also increased. Based on simulation, it was found that The maximum height of surgical smoke rising right above the incision of electro-surgical unit was increased with rising temperature of electro-surgical knife tip. There was a spread route of dispersed surgical smoke near the walls of theatre through natural convection. The polynomial fitting relationship was derived. As the tip temperature of knife increased from 200 to 500°C, maximum ascending height of surgical smoke right above the incision position of electro-surgical unit increased from 1.1 m to 1.45 m. When the tip temperature of electro-knife was more 400°C, the CO content in the surgeon's operating zone was more than 200 ppm, which would cause the surgeon's HbCO level increased. As the patient's tissue in the wound during operation was open, when the electro-knife of more than 400°C, the content of condensed tar droplets and in-viable particle was higher than 20 g/m3 and 12 g/m3 in the zone around patient's wound of open tissue, which should be hazard to health of patient.
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Affiliation(s)
- Hui Yu
- Department of Gynaecology and Obstetrics, Huazhong University of Science and Technology Hospital, Wuhan, Hubei Province, China
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Ran J, El-Kebir H, Lee Y, Chamorro LP, Berlin R, Aguiluz Cornejo GM, Benedetti E, Giulianotti PC, Bhargava R, Bentsman J, Ostoja-Starzewski M. Heat conduction in live tissue during radiofrequency electrosurgery. J R Soc Interface 2024; 21:20230420. [PMID: 38228182 PMCID: PMC10791539 DOI: 10.1098/rsif.2023.0420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Accepted: 12/11/2023] [Indexed: 01/18/2024] Open
Abstract
In this paper, we propose a method to model radiofrequency electrosurgery to capture the phenomena at higher temperatures and present the methods for parameter estimation. Experimental data taken from our surgical trials performed on in vivo porcine liver show that a non-Fourier Maxwell-Cattaneo-type model can be suitable for this application when used in combination with an Arrhenius-type model that approximates the energy dissipation in physical and chemical reactions. The resulting model structure has the advantage of higher accuracy than existing ones, while reducing the computation time required.
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Affiliation(s)
- Junren Ran
- Department of Mechanical Science and Engineering, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Hamza El-Kebir
- Department of Aerospace Engineering, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Yongseok Lee
- Department of Mechanical Science and Engineering, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Leonardo P. Chamorro
- Department of Mechanical Science and Engineering, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Richard Berlin
- Department of Mechanical Science and Engineering, University of Illinois at Urbana-Champaign, Urbana, IL, USA
- Carle Foundation Hospital, Urbana, IL, USA
| | | | - Enrico Benedetti
- Department of Surgery, University of Illinois at Chicago, Chicago, IL, USA
| | | | - Rohit Bhargava
- Department of Mechanical Science and Engineering, University of Illinois at Urbana-Champaign, Urbana, IL, USA
- Department of Bioengineering, University of Illinois at Urbana-Champaign, Urbana, IL, USA
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Joseph Bentsman
- Department of Mechanical Science and Engineering, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Martin Ostoja-Starzewski
- Department of Mechanical Science and Engineering, University of Illinois at Urbana-Champaign, Urbana, IL, USA
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, IL, USA
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Li K, Xie Y, Yang S, Ritasalo R, Mariam J, Yu M, Bi J, Ding H, Lu L. Synergetic Effects of Nanoscale ALD-HfO 2 Coatings and Bionic Microstructures for Antiadhesive Surgical Electrodes: Improved Cutting Performance, Antibacterial Property, and Biocompatibility. ACS APPLIED MATERIALS & INTERFACES 2023; 15:43550-43562. [PMID: 37672350 DOI: 10.1021/acsami.3c09374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/08/2023]
Abstract
The high temperature induced by surgical electrodes is highly susceptible to severe surface adhesion and thermal damage to adjacent tissues, which is a major challenge in improving the quality of electrosurgery. Herein, we reported a coupled electrode with micro/nano hierarchical structures fabricated by depositing nanoscale hafnium oxide (HfO2) coatings on bionic microstructures (BMs) via laser texturing, acid washing, and atomic layer deposition (ALD) techniques. The synergistic effect of HfO2 coatings and BMs greatly enhanced the hemophobicity of the electrode with a blood contact angle of 162.15 ± 3.16°. Furthermore, the coupled surface was proven to have excellent antiadhesive properties to blood when heated above 100 °C, and the underlying mechanism was discussed. Further experiments showed that the coupled electrode had significant advantages in reducing cutting forces, thermal damage, and tissue adhesion mass. Moreover, the antibacterial rates against Escherichia coli and Staphylococcus aureus were 97.2% and 97.9%, respectively. In addition, the noncytotoxicity levels of HfO2 coatings were verified by cell apoptosis and cycle assays, indirectly endowing the coupled electrode with biocompatibility. Overall, the coupled electrode was shown to have broad potential for application in the field of electrosurgery, and this work could provide new insights into antiadhesion properties under high-temperature conditions.
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Affiliation(s)
- Kaikai Li
- School of Mechanical & Automotive Engineering, South China University of Technology, Guangzhou 510641, China
| | - Yingxi Xie
- School of Mechanical & Automotive Engineering, South China University of Technology, Guangzhou 510641, China
| | - Shu Yang
- School of Mechanical & Automotive Engineering, South China University of Technology, Guangzhou 510641, China
| | | | | | - Min Yu
- Department of General Surgery, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Guangzhou 510080, China
| | - Junming Bi
- Department of Urology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou 510080, China
| | - Huanwen Ding
- Department of Orthopedics, Guangzhou First People's Hospital, Guangzhou 510180, China
| | - Longsheng Lu
- School of Mechanical & Automotive Engineering, South China University of Technology, Guangzhou 510641, China
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Local thermal effect of power-on setting on monopolar coagulation: a three-dimensional electrothermal coupled finite element study. Med Biol Eng Comput 2022; 60:3525-3538. [DOI: 10.1007/s11517-022-02689-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 10/02/2022] [Indexed: 11/07/2022]
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Gueli Alletti S, Rosati A, Capozzi VA, Pavone M, Gioè A, Cianci S, Chiantera V, Vizzielli G, Scaglione G, Fagotti A, Scambia G. Use of Laparoscopic and Laparotomic J-Plasma Handpiece in Gynecological Malignancies: Results From A Pilot Study in A Tertiary Care Center. Front Oncol 2022; 12:868930. [PMID: 35837114 PMCID: PMC9274254 DOI: 10.3389/fonc.2022.868930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 05/16/2022] [Indexed: 12/02/2022] Open
Abstract
Introduction The J-Plasma has recently been introduced into the surgical community with different intrinsic characteristics aimed to further reduce the thermal effect and enhance precision when compared to standard radiofrequency. This study aimed to investigate the role of this new technology in different conditions of gynecological carcinomatosis characterized by the indication for regional peritonectomy and/or ablation, either in laparotomy (LPT) or in laparoscopy (LPS), in the context of a modern personalized approach to the surgical management of gynecological malignancies. Material and Methods From January 2019 to April 2019, 12 patients were selected for this prospective pilot study at the Division of Gynecologic Oncology, Fondazione Policlinico Universitario A. Gemelli IRCCS in Rome. In this single surgeon experience, the inclusion criteria were: histologically proven advanced ovarian/endometrial cancer, primary or interval debulking surgery, and intraoperative indication for regional peritonectomy. Six patients were treated by LPS (Group 1) and 6 by LPT (Group 2). Results In Group 1 the indication for debulking surgery was in 4 cases an interval debulking surgery and 2 advanced endometrial cancer. All patients in Group 2 underwent primary debulking surgery for advanced ovarian cancer. The whole cohort achieved a complete tumor excision after surgery. The median OT and median EBL were 195 min and 100 ml in Group 1, and 420 min and 500 ml in Group 2. The median hospital stay was 4 days in Group 1 and 13 days in Group 2, respectively. No intra and postoperative complications were registered within 60 days after surgery. Conclusions J-Plasma allows to approach delicate maneuvers on viscera, mesentery, and blood vessels with a high degree of safety and precision thanks to its limited vertical and lateral thermal spread, favoring the surgeon to push ever higher the cytoreduction/morbidity tradeoff. The use of J-Plasma in cytoreductive surgery could also increase the range of possible minimally invasive procedures, narrowing the technical distance with the open technique and thus contributing to designing a personalized surgical strategy for each patient in different scenarios of peritoneal carcinomatosis.
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Affiliation(s)
- Salvatore Gueli Alletti
- Dipartimento per la salute della Donna e del Bambino e della Salute Pubblica, Fondazione Policlinico Universitario A. Gemelli, IRCCS, UOC Ginecologia Oncologica, Rome, Italy
- Università Cattolica del Sacro Cuore, Rome, Italy
- UOC Ginecologica e Ostetricia, Dipartimento Materno-Infantile, Ospedale Buccheri La Ferla Fatebenefratelli, Palermo, Italy
| | - Andrea Rosati
- Dipartimento per la salute della Donna e del Bambino e della Salute Pubblica, Fondazione Policlinico Universitario A. Gemelli, IRCCS, UOC Ginecologia Oncologica, Rome, Italy
- *Correspondence: Andrea Rosati,
| | - Vito Andrea Capozzi
- Department of Gynecology and Obstetrics of Parma, University of Parma, Parma, Italy
| | | | | | - Stefano Cianci
- Department of Gynecologic Oncology and Minimally-Invasive Gynecologic Surgery, Università degli studi di Messina, Policlinico G. Martino, Messina, Italy
| | - Vito Chiantera
- Department of Gynecologic Oncology, Aziende di Rilievo Nazionale di Alta Specializzazione, Civico Di Cristina Benfratelli, Palermo, Italy
- Department of Gynecologic Oncology, Università di Palermo, Palermo, Italy
| | - Giuseppe Vizzielli
- Dipartimento per la salute della Donna e del Bambino e della Salute Pubblica, Fondazione Policlinico Universitario A. Gemelli, IRCCS, UOC Ginecologia Oncologica, Rome, Italy
- Obstetrics, Gynecology and Pediatrics Department, Udine University Hospital, DAME, Udine, Italy
| | - Giulia Scaglione
- Department of Woman, Child and Public Health Sciences, Gynecopathology and Breast Pathology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | | | - Giovanni Scambia
- Dipartimento per la salute della Donna e del Bambino e della Salute Pubblica, Fondazione Policlinico Universitario A. Gemelli, IRCCS, UOC Ginecologia Oncologica, Rome, Italy
- Università Cattolica del Sacro Cuore, Rome, Italy
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Lai X, Nie M, Xu X, Chen Y, Guo Z. Delayed bowel perforation after instilling over warmed peritoneal dialysate. BMC Nephrol 2021; 22:139. [PMID: 33879076 PMCID: PMC8056609 DOI: 10.1186/s12882-021-02343-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 04/08/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Peritoneal dialysis (PD) is a safe and home-based treatment for end-stage renal disease (ESRD) patients. The direct thermal damage of abdominal organs is very rare. CASE PRESENTATION We report a peritoneal dialysis patient presented abdominal pain and feculent effluent 3 weeks after he instilled hot dialysis solution. In spite of emergency exploratory laparotomy and active treatment, the patient died of septic shock. Biopsy revealed necrosis and perforation of the intestines. CONCLUSIONS Delayed bowel perforation by hot fluid is very rare. Standardized performance is of the first importance for peritoneal dialysis patients.
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Affiliation(s)
- Xueli Lai
- Department of Nephrology, Shanghai Changhai Hospital, 168 Changhai Road, Shanghai, 200433, P.R. China
| | - Mingming Nie
- Department of Gastroenterology, Shanghai Changhai Hospital, 168 Changhai Road, Shanghai, 200433, P.R. China
| | - Xiaodong Xu
- Department of Colorectal Surgery, Shanghai Changhai Hospital, 168 Changhai Road, Shanghai, 200433, P.R. China
| | - Yuanjie Chen
- Intensive Care Unit, Shanghai Changhai Hospital, 168 Changhai Road, Shanghai, 200433, P.R. China
| | - Zhiyong Guo
- Department of Nephrology, Shanghai Changhai Hospital, 168 Changhai Road, Shanghai, 200433, P.R. China.
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Karaki W, Rahul, Lopez CA, Borca Tasciuc DA, De S. A continuum thermomechanical model for the electrosurgery of soft hydrated tissues using a moving electrode. Comput Methods Biomech Biomed Engin 2020; 23:1317-1335. [PMID: 32744457 DOI: 10.1080/10255842.2020.1798415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Electrosurgical radio-frequency heating of tissue is widely applied in minimally invasive surgical procedures to dissect tissue with simultaneous coagulation to obtain hemostasis. The tissue effect depends on the cumulative heating that occurs in the vicinity of the moving blade electrode. In this work, a continuum thermomechanical model based on mixture theory, which accounts for the multiphase nature of soft hydrated tissues and includes transport and evaporation losses, is used to capture the transient heating effect of a moving electrode. The model takes into account the dependence of electrical conductivity and the evaporation rate on the water content in the tissue, as it changes in response to heating. Temperature prediction is validated with mean experimental temperature measured during in situ experiments performed on porcine liver tissue at different power settings of the electrosurgical unit. The model is shown to closely capture the temperature variation in the tissue for three distinct scenarios; with no visible cutting or coagulation damage at a low 10 W power setting, with coagulation damage but no tissue cutting at an intermediate power setting of 25 W, and with both coagulation and tissue cutting at a higher power setting of 50 W. Furthermore, an Arrhenius model is shown to capture tissue damage observed in the experiments. Increase in applied power was found to correlate with tissue cutting and concentrated damage near the electrode, but had little effect on the observed coagulation damage width. The proposed model provides, for the first time, an accurate tool for predicting temperature rise and evolving damage resulting from a moving electrode in pure-cut electrosurgery.
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Affiliation(s)
- Wafaa Karaki
- Center for Modeling, Simulation and Imaging in Medicine, Rensselaer Polytechnic Institute, Troy, NY, USA
| | - Rahul
- Center for Modeling, Simulation and Imaging in Medicine, Rensselaer Polytechnic Institute, Troy, NY, USA
| | - Carlos A Lopez
- Center for Modeling, Simulation and Imaging in Medicine, Rensselaer Polytechnic Institute, Troy, NY, USA
| | - Diana-Andra Borca Tasciuc
- Center for Modeling, Simulation and Imaging in Medicine, Rensselaer Polytechnic Institute, Troy, NY, USA
| | - Suvranu De
- Center for Modeling, Simulation and Imaging in Medicine, Rensselaer Polytechnic Institute, Troy, NY, USA
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Nechay TV, Titkova SM, Anurov MV, Mikhalchik EV, Melnikov-Makarchyk KY, Ivanova EA, Tyagunov AE, Fingerhut A, Sazhin AV. Thermal effects of monopolar electrosurgery detected by real-time infrared thermography: an experimental appendectomy study. BMC Surg 2020; 20:116. [PMID: 32460827 PMCID: PMC7251678 DOI: 10.1186/s12893-020-00735-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Accepted: 04/05/2020] [Indexed: 01/09/2023] Open
Abstract
Background Monopolar energy (ME) is routinely used in appendectomy. This study aimed to investigate the degree of lateral thermal spread generated by ME and to evaluate the thermal injury sustained by the close-lying tissues. Methods Appendectomy with a monopolar Maryland dissector was performed in 8 rabbits (at 30 and 60 W power settings). A high-resolution infrared camera was used to record tissue heating during the intervention. After autopsy macroscopic changes were evaluated and tissue samples were subjected to myeloperoxidase (MPO) assay and histological examination. Results No significant differences in the extent of thermal spread, MPO activity and histological signs of inflammation were observed between groups. Regardless of the power settings, the heat spread exceeded 2 cm laterally along the mesoappendix when application time exceeded 3 s. The spread of heat through tubular structures in both groups caused a significant temperature rise in the nearby intestinal loop, resulting in perforation (n = 3) and necrosis (n = 1). Conclusions Application time is critical in thermal spread during appendectomy aided by ME. Tubular anatomic structures can enhance thermal injury on distant tissues. The observed effects of ME bear clinical relevance that need further investigation.
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Affiliation(s)
- Taras V Nechay
- Pirogov Russian National Research Medical University, Ostrovitianov str. 1, Moscow, 117997, Russia.
| | - Svetlana M Titkova
- Pirogov Russian National Research Medical University, Ostrovitianov str. 1, Moscow, 117997, Russia
| | - Mikhail V Anurov
- Pirogov Russian National Research Medical University, Ostrovitianov str. 1, Moscow, 117997, Russia
| | - Elena V Mikhalchik
- Research and Clinical Center for Physical-Chemical Medicine, Malaya Pirogovskaya 1a, Moscow, 119435, Russia
| | | | - Ekaterina A Ivanova
- Pirogov Russian National Research Medical University, Ostrovitianov str. 1, Moscow, 117997, Russia
| | - Alexander E Tyagunov
- Pirogov Russian National Research Medical University, Ostrovitianov str. 1, Moscow, 117997, Russia
| | - Abe Fingerhut
- Section for Surgical Research, Department of Surgery, Medical University of Graz, 8036, Graz, Austria.,Department of Gastrointestinal Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 20025, China
| | - Alexander V Sazhin
- Pirogov Russian National Research Medical University, Ostrovitianov str. 1, Moscow, 117997, Russia
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Shlykov V, Kotovskyi V, Dubko A, Višniakov N, Šešok A. Temperature monitoring for high frequency welding of soft biological tissues: A prospective study. Technol Health Care 2019; 27:643-649. [PMID: 31033469 DOI: 10.3233/thc-191613] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Monitoring of temperature changes and accurately determining the moment of electrode removal during open heart operations is not well recognized. OBJECTIVE We investigated the temperature fields distribution in the biological tissues affected by electrosurgery upon use of an infrared thermograph. METHODS The dynamics of temperature distribution in the tissue was registered by the thermal imaging camera FLIR i7. Measurement of the temperature between electrode couples was carried out for two operation modes: coagulation (100% power) and coagulation (50% power). RESULTS The most important result of the applied method of temperature monitoring is a determination of the moment for electrodes removal that ensures the avoidance of carbonization of the cardiac tissues during their ablation. CONCLUSIONS Temperature monitoring for connection of soft live biological tissues by welding allows the power to be fed in the amount sufficient for a formation of continuous ablation of the myocardium tissue.
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Affiliation(s)
- Vladyslav Shlykov
- Department of Biomedical Engineering, National Technical University of Ukraine "Igor Sikorsky Kyiv Polytechnic Institute", Kiev, Ukraine
| | - Vitalii Kotovskyi
- Department of General Physics and Solid State Physics, National Technical University of Ukraine "Igor Sikorsky Kyiv Polytechnic Institute", Kiev, Ukraine
| | - Andrey Dubko
- E.O. Paton Electric Welding Institute of the National Academy of Sciences of Ukraine, Kiev, Ukraine
| | - Nikolaj Višniakov
- Department of Mechanics and Material Engineering, Vilnius Gediminas Technical University, Vilnius, Lithuania
| | - Andžela Šešok
- Department of Biomechanics Engineering, Vilnius Gediminas Technical University, Vilnius, Lithuania
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Karaki W, Lopez CA, Borca-Tasciuc DA, De S. A continuum thermomechanical model of in vivo electrosurgical heating of hydrated soft biological tissues. INTERNATIONAL JOURNAL OF HEAT AND MASS TRANSFER 2018; 127:961-974. [PMID: 30739950 PMCID: PMC6366672 DOI: 10.1016/j.ijheatmasstransfer.2018.07.006] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Radio-frequency (RF) heating of soft biological tissues during electrosurgical procedures is a fast process that involves phase change through evaporation and transport of intra- and extra-cellular water, and where variations in physical properties with temperature and water content play significant role. Accurately predicting and capturing these effects would improve the modeling of temperature change in the tissue allowing the development of improved instrument design and better understanding of tissue damage and necrosis. Previous models based on the Pennes' bioheat model neglect both evaporation and transport or consider evaporation through numerical correlations, however, do not account for changes in physical properties due to mass transport or phase change, nor capture the pressure increase due to evaporation within the tissue. While a porous media approach can capture the effects of evaporation, transport, pressure and changes in physical properties, the model assumes free diffusion of liquid and gas without a careful examination of assumptions on transport parameters in intact tissue resulting in significant under prediction of temperature. These different approaches have therefore been associated with errors in temperature prediction exceeding 20% when compared to experiments due to inaccuracies in capturing the effects of evaporation losses and transport. Here, we present a model of RF heating of hydrated soft tissue based on mixture theory where the multiphase nature of tissue is captured within a continuum thermomechanics framework, simultaneously considering the transport, deformation and phase change losses due to evaporation that occur during electrosurgical heating. The model predictions are validated against data obtained for in vivo ablation of porcine liver tissue at various power settings of the electrosurgical unit. The model is able to match the mean experimental temperature data with sharp gradients in the vicinity of the electrode during rapid low and high power ablation procedures with errors less than 7.9%. Additionally, the model is able to capture fast vaporization losses and the corresponding increase in pressure due to vapor buildup which have a significant effect on temperature prediction beyond 100 °C.
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Affiliation(s)
- Wafaa Karaki
- Center for Modeling, Simulation and Imaging in Medicine, Rensselaer Polytechnic Institute, Troy, NY, USA
| | - Carlos A Lopez
- Center for Modeling, Simulation and Imaging in Medicine, Rensselaer Polytechnic Institute, Troy, NY, USA
| | - Diana-Andra Borca-Tasciuc
- Center for Modeling, Simulation and Imaging in Medicine, Rensselaer Polytechnic Institute, Troy, NY, USA
| | - Suvranu De
- Center for Modeling, Simulation and Imaging in Medicine, Rensselaer Polytechnic Institute, Troy, NY, USA
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Zheng L, Wan J, Long Y, Fu H, Zheng J, Zhou Z. Effect of high-frequency electric field on the tissue sticking of minimally invasive electrosurgical devices. ROYAL SOCIETY OPEN SCIENCE 2018; 5:180125. [PMID: 30109069 PMCID: PMC6083695 DOI: 10.1098/rsos.180125] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Accepted: 06/04/2018] [Indexed: 06/08/2023]
Abstract
Generally minimally invasive surgery is performed using an endoscope and other instruments including electrosurgical units (ESUs), and the adhesion of tissue to electrodes is a major concern. The mechanism governing this tissue sticking, especially the influence of high-frequency electric field, is still unclear. In this study, the effect of high-frequency electric field on the tissue sticking upon electrodes was investigated. The electrosurgical cutting test was performed on ex vivo fresh porcine liver under blend mode using a monopolar ESU. A heat-adherence test without electric field was used as a control. For the control group, the electrode was heated and maintained at a certain temperature and directly in contact with porcine liver. Both sticking tissues obtained from these two tests are partially carbonized porcine liver tissue, but their microstructure and bonding with electrode are obviously different. The sticking tissue formed just under heat is composed of biggish nanoparticles of different sizes which are loosely aggregated and has a weak bonding with the electrode, while the sticking tissue from the electrosurgical cutting test consists of tightly packed fine nanoparticles of equable size as a result of thermo-electric coupling and has a strong bonding with the electrode. Obviously, high-frequency electric field plays an extremely important role in the formation of the sticking tissue. It is the thermo-electric coupling that underlies the function of minimally invasive electrosurgical devices, and the effect of high-frequency electric field cannot be ignored in the tissue sticking study and anti-sticking strategies.
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Affiliation(s)
- Liang Zheng
- Tribology Research Institute, Key Laboratory of Advanced Technologies of Materials, Ministry of Education of China, Southwest Jiaotong University, Chengdu 610031, People's Republic of China
- School of Life Science and Engineering, Southwest Jiaotong University, Chengdu 610031, People's Republic of China
| | - Jianfei Wan
- Tribology Research Institute, Key Laboratory of Advanced Technologies of Materials, Ministry of Education of China, Southwest Jiaotong University, Chengdu 610031, People's Republic of China
| | - Yunjiang Long
- Tribology Research Institute, Key Laboratory of Advanced Technologies of Materials, Ministry of Education of China, Southwest Jiaotong University, Chengdu 610031, People's Republic of China
| | - Helin Fu
- Tribology Research Institute, Key Laboratory of Advanced Technologies of Materials, Ministry of Education of China, Southwest Jiaotong University, Chengdu 610031, People's Republic of China
| | - Jing Zheng
- Tribology Research Institute, Key Laboratory of Advanced Technologies of Materials, Ministry of Education of China, Southwest Jiaotong University, Chengdu 610031, People's Republic of China
| | - Zhongrong Zhou
- Tribology Research Institute, Key Laboratory of Advanced Technologies of Materials, Ministry of Education of China, Southwest Jiaotong University, Chengdu 610031, People's Republic of China
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Kojima S, Sakamoto T, Honda M, Nishiguchi R, Ogawa F. Rare complication after totally extraperitoneal endoscopic inguinal hernia repair: Small bowel perforation without peritoneal disruption. Asian J Endosc Surg 2016; 9:311-313. [PMID: 27165987 DOI: 10.1111/ases.12294] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2016] [Revised: 03/29/2016] [Accepted: 04/03/2016] [Indexed: 12/18/2022]
Abstract
We report a rare case of visceral injury after totally extraperitoneal endoscopic inguinal hernia repair. A 48-year-old man underwent needlescopic totally extraperitoneal repair of a direct inguinal hernia. Bleeding from a branch of the inferior epigastric vessels occurred at the beginning of the extraperitoneal dissection with a monopolar electrosurgical device. Hemostasis was prolonged. However, herniorrhaphy and mesh repair were successfully performed, and no peritoneal disruption or pneumoperitoneum was visible. The patient was discharged home on the next day. However, 30 h after this operation, he underwent diagnostic and operative laparoscopy because of acute abdominal pain. Ileal perforation was found and repaired, and pathological examination indicated cautery artifact. Thus, thermal damage to the ileum during the initial operation may have caused the bowel perforation. To the best of our knowledge, no other cases of bowel perforation after totally extraperitoneal repair without peritoneal disruption have been reported.
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Affiliation(s)
- Shigehiro Kojima
- Department of Surgery, Sainokuni Higashiomiya Medical Center, Saitama, Japan.
| | - Tsuguo Sakamoto
- Department of Surgery, Sainokuni Higashiomiya Medical Center, Saitama, Japan
| | - Masayuki Honda
- Department of Surgery, Sainokuni Higashiomiya Medical Center, Saitama, Japan
| | - Ryohei Nishiguchi
- Department of Surgery, Sainokuni Higashiomiya Medical Center, Saitama, Japan
| | - Fumihiro Ogawa
- Department of Pathology, Sainokuni Higashiomiya Medical Center, Saitama, Japan
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13
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Karaki W, Akyildiz A, De S, Borca Tasciuc DA. Energy Dissipation in Ex Vivo Porcine Liver During Electrosurgery. IEEE Trans Biomed Eng 2016; 64:1211-1217. [PMID: 27479955 DOI: 10.1109/tbme.2016.2595525] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
This paper explores energy dissipation in ex vivo liver tissue during radiofrequency current excitation with application in electrosurgery. Tissue surface temperature for monopolar electrode configuration is measured using infrared thermometry. The experimental results are fitted to a finite-element model for transient heat transfer taking into account energy storage and conduction in order to extract information about "apparent" specific heat, which encompasses storage and phase change. The average apparent specific heat determined for low temperatures is in agreement with published data. However, at temperatures approaching the boiling point of water, apparent specific heat increases by a factor of five, indicating that vaporization plays an important role in the energy dissipation through latent heat loss.
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14
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Comparison of the effects of surgical dissection devices on the rabbit liver. Surg Today 2013; 44:1116-22. [DOI: 10.1007/s00595-013-0712-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2012] [Accepted: 04/21/2013] [Indexed: 10/26/2022]
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15
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Robert R, Chen L, Shanbhag R, Drozek D, Choi J. Method for Detecting Ablation Damage Using Sensor Integration of Hot Biopsy Forceps. J Med Device 2013. [DOI: 10.1115/1.4024348] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Affiliation(s)
- Randolph Robert
- Department of Mechanical Engineering, Ohio University, Athens, OH
| | - Liang Chen
- Biomedical Engineering Program, Ohio University, Athens, OH
| | - Rajesh Shanbhag
- Department of Mechanical Engineering, Ohio University, Athens, OH
| | - David Drozek
- Department of Specialty Medicine, Ohio University, Athens, OH, USA
| | - JungHun Choi
- Department of Mechanical Engineering, Biomedical Engineering Program, Ohio University, Athens, OH
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