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PubMed1987

Per-endoscopic bipolar diathermy coagulation of visible vessels using a 3.2 mm probe--a randomised clinical trial.

Forty-four patients who had bled from peptic ulcers and whose ulcers showed stigmata of haemorrhage (bleeding, visible vessel or adherent clot) entered a trial of treatment with a 3.2 mm bipolar diathermy probe. Two patients had spurting haemorrhage when endoscoped and both were treated with the probe, control being obtained in one. The remaining patients were randomised to treatment or control groups. One patient who was treated was withdrawn because the ulcer proved to be malignant. Six of 20 treated patients rebled compared with 8 of 21 controls (relative risk 0.79; 90% CI 0.26-1.97). The operation rate, transfusion requirement and hospital stay were similar in the two groups. One perforation occurred in the treatment group. Per-endoscopic bipolar diathermy treatment confers little benefit in bleeding peptic ulcer disease.

Aged↗
PubMed2000

Retrograde endopyelotomy using an original home-made diathermy probe.

PURPOSE: To describe an easily home-made diathermy probe for the performance of retrograde endopyelotomies using a small-caliber rigid ureteroscope. METHODS: The diathermy probe is easily built by putting a rigid guidewire through a 5F ureteral catheter, the distal tip being naked and slightly bent. The other end is linked to the electric generator. Among a total of 24 retrograde endopyelotomies performed to treat ureteropelvic junction obstruction in the last 7 years, five were done using this device. RESULTS: Surgery with the probe took an average of 30 minutes. There were no complications, and, as of today, all cases are successes. CONCLUSION: This device allows the performance of retrograde endopyelotomy using a small-caliber ureteroscope. Long-term results will presumably match the good results obtained using the larger-caliber ureteroscopes with the classic cold knife.

Adolescent↗
PubMed2000

Long-term GnRH analogue treatment is equivalent to laparoscopic laser diathermy in polycystic ovarian syndrome patients with severe ovarian dysfunction.

This prospective, randomized study included 18 polycystic ovarian syndrome (PCOS) patients with severe ovarian dysfunction, who were evaluated by standard clomiphene and FSH stimulation. In this group of patients, a 6 month down-regulation with gonadotrophin-releasing hormone (GnRH) analogues gave outcomes similar to laparoscopic ovarian laser diathermy with respect to stimulatory outcome and pregnancy rate. Clomiphene stimulation with 50 mg of clomiphene/day and FSH stimulation in a low-dose, step-up protocol with purified FSH did not result in oligofollicular development; thus patients were divided into two subgroups: one subgroup received laparoscopic laser drilling and the other received 6 months of therapy with GnRH analogues plus add-back therapy after diagnostic laparoscopy. Subsequently, three cycles of low-dose, step-up stimulation with recombinant FSH were started. In both groups, approximately 30% of cycles still remained anovulatory. In the down-regulated subgroup, this mainly happened in the first cycle. In each group, ovulation was achieved in 14 cycles, intrauterine insemination was performed, and five pregnancies were obtained. This resulted in a pregnancy rate of 36% per ovulatory cycle in both groups. Overall, 50% of the formerly unreactive patients in both groups overcame childlessness. In achieving this, long-term treatment with GnRH analogues was as successful as laparoscopic laser diathermy.

Adult↗
PubMedDate not supplied

Penetrating diathermy for retinal microincarceration in the management of giant retinal tears with inverted flaps.

Using vitrectomy, fluid-air exchange, penetrating diathermy, and scleral buckling, surgical success was achieved in 24 of 27 eyes with inverted giant retinal tears (GRTs) and concomitant unfavorable conditions. The follow-up period ranged from 6-52 months. Anatomic success was achieved in 18 eyes. Tears larger than 300 degrees with immobile flaps or advanced proliferative vitreoretinopathy (PVR) contributed significantly to surgical failure (P less than .05). Preoperative (greater than C2) and postoperative PVR figured significantly in unimproved final visual acuity (P less than .05). Penetrating diathermy was effective in fixating the repositioned retina, with little complication. Postoperative therapy with fluid-gas or air exchange or photocoagulation greatly enhanced final success.

Adolescent↗
PubMedDate not supplied

Burns as a complication of the use of diathermy.

Surgical diathermy is an invaluable aid in modern surgery, and most contemporary diathermy machines are considered safe. The literature has proven to be very sparse in terms of reference to complications, although prolonged courses of treatment are required in individual cases. We report a case of burns that occurred during a saphenous vein coronary bypass graft caused by the inadequate use of the electrosurgical materials. Care should be taken in the use of these resources to avoid complications of this kind.

Aged↗
PubMed1992

A comparison of laser cautery and sub-mucosal diathermy for rhinitis.

A randomized prospective trial was conducted to compare the efficacy of laser cautery against sub-mucosal diathermy to the inferior turbinates in 29 patients with rhinitis. Laser diathermy was performed using an arthroscopic fitment to a CO2 laser. Subjective and objective measurement of airway obstruction were performed, using a linear analogue scale and a nasal peak inspiratory flow meter, before operation and at 3 days and 6 weeks afterwards. In both groups there was a similar and significant improvement in subjective scores at 6 weeks (SMD from 3.6 to 1.8, P less than 0.01; laser from 3.9 to 2.1, P less than 0.001), but only the laser group was significantly better at Day 3 (SMD from 3.6 to 3.5, n.s.; laser from 3.9 to 3.0, P less than 0.05). In addition, there was significantly more general subjective morbidity at Day 3 in the SMD group (P less than 0.01). The objective scores improved equally in both groups but were not significant. We conclude that laser cautery of the inferior turbinate is a superior alternative to SMD for the treatment of rhinitis.

Adult↗
PubMed2004

The ultrasonically activated scalpel versus bipolar diathermy for tonsillectomy: a prospective, randomized trial.

Among patients undergoing tonsillectomy, the ultrasonic scalpel has been reported to lead to less intraoperative blood loss than cold dissection, and less postoperative pain and faster recovery than monopolar electrocautery. However, the ultrasonic scalpel has not been compared with bipolar diathermy. The present study was a prospective, randomized, single-blind trial, comparing these two techniques with respect to postoperative pain. Twenty-one adults underwent tonsillectomy on one side using the ultrasonic scalpel, and on the other using bipolar diathermy. Pain scores were obtained on postoperative days 1, 2, 7 and week 3. There was no difference between the two treatments at any of the time points (P = 0.6047, 0.4018, 0.6047 and 0.5000, respectively). Inability to control bleeding with the ultrasonic scalpel resulted in the rescue use of an alternative technique of haemostasis in 14 cases. We conclude that the use of the ultrasonic scalpel in adult tonsillectomy is likely to be limited by its substantial costs and difficulties with haemostasis.

Adolescent↗
PubMed1987

Treatment of cervical intraepithelial neoplasia (CIN) by radical electrocoagulation diathermy: 5 years' experience.

During the first 5 years of a colposcopy clinic established in a London teaching hospital 653 new patients were seen, usually referred because they had had an abnormal cervical smear report suggesting cervical intraepithelial neoplasia (CIN). Of 490 women treated within the district for CIN, 361 (73.7%) underwent radical electrocoagulation diathermy, 91 (18.6%) were treated by cone biopsy, 34 (6.9%) underwent hysterectomy and the other four patients were treated by cryocautery. Of the 245 women treated by radical electrocoagulation diathermy who have been followed for at least 12 months, persistent or recurrent disease has been found in only 15, a first time treatment success rate of 93.9%.

Colposcopy↗
PubMed1993

Bronchoscopic diathermy resection and stent insertion: a cost effective treatment for tracheobronchial obstruction.

BACKGROUND: Major airways obstruction is a distressing cause of morbidity and mortality. For disease that is extensive and recurrent, there is a need for a safe and cost effective technique for palliation. METHODS: The results of 29 patients with tracheobronchial obstruction (24 malignant and five benign) treated by diathermy resection alone or in combination with endobronchial stenting have been reviewed. RESULTS: The major site of obstruction was the trachea in 14, main carina in seven, right main bronchus in six, and left main bronchus in two patients. Fifteen had received other forms of treatment beforehand including external radiotherapy, endoscopic dilatation, and laser resection (Nd:YAG). Five patients required two or more treatment sessions for symptom recurrence. Ten patients also received additional treatment with a stent (nine) or insertion of gold grains (one). There were no intraoperative deaths or complications and the average length of stay was five days (range 2-14). Twenty eight patients reported immediate symptomatic relief, and objective improvement in the results of lung function tests was seen in eight patients whose condition was less acute and where preoperative lung function tests could be undertaken (average improvement in FEV1 of 53.1% and in FVC of 20.6%). CONCLUSIONS: Bronchoscopic diathermy resection is an effective and safe method for relieving the symptoms of tracheobronchial obstruction at appreciably less cost than laser resection.

Adult↗
PubMed1985

Submucosal diathermy of the inferior turbinate and the congested nose.

Surgical correction of the congested nose is frequently attempted. In the absence of a septal deformity, engorgement of the inferior turbinate is usually held to be the culprit, and various procedures have been advocated to counter this problem. Submucosal diathermy to the inferior turbinates is widely practised, but relatively little has been published about it. 204 patients who underwent submucosal diathermy of the inferior turbinates between 1977 and 1983 have been studied. 60 patients have been followed up by questionnaire, for periods ranging from 1 to 5 years since surgery. Surgery was of benefit in up to 72% of cases. Surgical technique and the problems of patient selection and assessment are discussed.

Adolescent↗
PubMed1981

Histopathologic evaluation of adhesive properties of early lesions in diathermy and cryopexy.

We examined the histopathologic appearance of both cryopexy and diathermy lesions, 10-60 min after application in the rabbit retina. Both lesions showed immediate subretinal exudation. Thus, we could not substantiate the speculation that a diathermy lesion might have greater immediate adhesive strength than a cryotherapy lesion. This explains the clinical experience that retina tends to slip with either modality when trying to treat giant retinal tears.

Adhesiveness↗
PubMed2000

Inferior turbinectomy versus submucosal diathermy for inferior turbinate hypertrophy.

In order to compare and evaluate bilateral inferior turbinectomy (BIT) and submucosal diathermy (SMD), we retrospectively examined these two well-known techniques for treatment of nasal obstruction due to bilateral congestion of the inferior turbinates. One hundred patients with bilateral nasal obstruction were divided into 4 groups according to their nasal airflow patency. Forty-nine patients underwent BIT, and 51 patients underwent SMD. All 100 patients were followed for 2 months after surgery. Patients with difficult postoperative courses were followed up to 1 year after surgery, in order to decide on the necessity of operative revision. Postoperative improvement in nasal breathing after BIT was reported for 96% of patients 2 weeks after surgery, and for 88% 2 months after surgery. Only 1 BIT patient had to undergo revision operation. Diathermy showed good results in 78% of cases 2 weeks after surgery. The efficacy of the procedure was reduced to 76% 2 months after surgery. Twenty percent of SMD patients were advised to undergo operative revision. Postoperative bleeding occurred in 20% of BIT patients and in only 4% of SMD patients. We found that the extent of postoperative improvement does not depend on preoperative conditions; therefore, it is impossible to predict the extent of postoperative improvement on the basis of the results of preoperative assessment. Both procedures can be performed under local anesthesia, are relatively safe and effective, and do not need expensive instrumentation that may not be available in many medical centers.

Adolescent↗
PubMed1975

Cardiac pacemaker induced ventricular fibrillation during surgical diathermy.

Two demand pacemakers were observed to repeatedly fibrillate the heart during clinical surgery employing diathermy. Marked hypotension associated with a rapid, irregular venticular action was observed in another patient who had a fixed rate pacemaker implanted. Pacemakers were tested with function generators over a range of frequencies and some increased their rate to between 200-600 impulse/min. Animal experiments confirmed that, contrary to manufacturers advice, surgical diathermy produces myocardial fibrillation in the presence of some pacemakers. Mechanisms of these effects and their clinical significance are discussed.

Aged↗
PubMed1978

The surgical diathermy: principles of operation and safe use.

An understanding of the principles of operation and hazards of the surgical diathermy is necessary for the safety of the anaesthetized patient. The surgical diathermy performs its function by the application of high density radio frequency current which can be used to cut or coagulate tissue. Its improper use can result in electrical burns and even electrocution. The principles underlying its safe use are outlined, and detailed recommendations are made to ensure the patient's safety.

Disposable Equipment↗
PubMed2001

Diathermy epiglottectomy: endoscopic technique.

Endoscopic epiglottectomy is usually performed using a surgical laser. Epiglottectomy may be indicated for the treatment of benign or malignant lesions and for the relief of airway obstruction caused by a floppy epiglottis. We present four patients who had endoscopic partial epiglottectomy using monopolar diathermy to treat a floppy epiglottis. All the four patients were male in their sixth and seventh decades with snoring and/or obstructive sleep apnoea syndrome (OSAS) due partly or wholly to a floppy epiglottis. Diathermy epiglottectomy is easily carried out using the laryngoscope, laryngeal instruments and curved rotating microdissection monopolar scissors (used in laparoscopic surgery). This was found to be safe and effective with minimal morbidity. It requires no elaborate preparation and could be performed in hospitals that have no laser facilities. It may be performed in conjunction with other procedures e.g. uvulopalatopharyngoplasty (UPPP) if necessary.

Aged↗
PubMed2005

Suction diathermy adenoid ablation.

Adenoidectomy is a surgical procedure frequently carried out in otolaryngological practice, traditionally undertaken blindly with curettage using an adenotome following palpation of the adenoid bed. While a number of alternative methods have been described for surgical removal of the adenoid pad (power-assisted/microdebrider, transnasal adenoid ablation, suction coagulation and liquefaction/aspiration) none has become the definitive procedure. Suction diathermy adenoidectomy has been known and used for some time; it has gained in popularity over recent years and is established as an alternative to conventional curettage, particularly in children. We describe several techniques which improve the view of the surgical field while performing suction diathermy adenoid ablation.

Adenoidectomy↗
PubMed1999

Temperature change in human muscle during and after pulsed short-wave diathermy.

STUDY DESIGN: A time series design was used, with the dependent variable being gastrocnemius muscle temperature at a depth of 3 cm. OBJECTIVES: To determine the rate of temperature rise and the rate of post-treatment temperature decline in skeletal muscle following the application of pulsed short-wave diathermy (PSWD). BACKGROUND: Data on PSWD rate and longevity of heating are 20 years old and outdated. With the recent introduction of advanced diathermy equipment, results of our study would provide clinicians with much needed information regarding treatment duration. METHODS AND MEASURES: A 23-gauge thermistor was inserted into the center of the medial head of the anesthetized gastrocnemius muscle, 3 cm below the skin's surface of 20 subjects. The PSWD (27.12 MHz frequency) was applied using the following parameters: 800 bursts per second; 400 microseconds burst duration; 850 microseconds interburst interval; with a peak root mean square (RMS) amplitude of 150 W per burst and an average RMS output of 48 W. Temperature changes were documented every 5 minutes during the treatment and additionally at 5 and 10 minutes following treatment. RESULTS: The average baseline and peak temperatures were 35.84 +/- 0.93 degrees C and 39.80 +/- 0.83 degrees C, respectively. Mean temperature increases were: 1.36 +/- 0.90 degrees C (5 min); 2.87 +/- 1.44 degrees C (10 min); 3.78 +/- 1.19 degrees C (15 min); 3.49 +/- 1.13 degrees C (20 min). After the treatment terminated, intramuscular temperature dropped 0.97 +/- 0.68 degree C in 5 minutes and 1.78 +/- 0.69 degrees C in 10 minutes. CONCLUSIONS: PSWD is an effective modality if temperature elevation of deep tissue over a large area is the clinical objective.

Adult↗