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PubMed1991

Is diathermy safe in women with copper-bearing IUDs?

Ultrasound and short-wave diathermy are widely used in physiotherapy to induce heating of deep tissues, since this causes a concomitant increase in local blood flow. A metallic implant in the treated field is generally regarded as a contra-indication to diathermy because of the risk of thermodamage to surrounding tissues. It is not certain, however, if copperbearing IUDs contain sufficient metal as to constitute a risk. In order to exclude the possibility that diathermy might lead to intra-uterine burns in women using copperbearing IUDs a technique was devised of measuring temperatures in the copper wire of an IUD in situ during short-wave an ultrasonic therapy. The results indicate diathermy to be perfectly safe in women whit copper-bearing IUDs.

Body Temperature↗
PubMedDate not supplied

Diathermy haemorrhoidectomy: reasons for a therapeutic choice.

BACKGROUND: Diathermy haemorrhoidectomy is an effective technique for the management of 2nd, 3rd and 4th degree haemorrhoids. The anal cushions are excised by use of diathermy without ligature of the vascular pedicles. The aim of the present study is to evaluate the efficacy and tolerability of this technique. METHODS: Between September 1999 and September 2003, 84 patients with 2nd, 3rd, and 4th degree haemorrhoids underwent diathermy haemorrhoidectomy. Patients were discharged the same day or the day after. All the patients were asked to complete two questionnaires one on the level of pain they experienced and the other on their expectation of pain. Patients were followed-up for 1 to 4 years (range 12-48 months, mean 20.5). RESULTS: The average pain severity score on a visual analogue scale (0-10) was 3.06 +/- 0.38 and consistently lower than expected. The majority of patients returned to their usual daily activities within 4 days and all of them returned to work within 11 days. A mild residual secretion persisted for 4 to 5 weeks. None of our patients experienced postoperative haemorrhage, complete stenosis or sphincteric disturbances. CONCLUSIONS: Diathermy haemorrhoidectomy appears to be a safe, low cost and effective technique for the treatment of haemorrhoids. It is well tolerated by patients.

Activities of Daily Living↗
PubMed1984

Local muscle blood flow and temperature responses to 915MHz diathermy as simultaneously measured and numerically predicted.

The therapeutic benefits of diathermy are tied to the relationship thought to exist between tissue temperature and augmented blood flow (BF). To further define this relationship, simultaneous measurements of thigh muscle blood flow (MBF) and temperature have been made in 15 human subjects during 915MHz, direct-contact microwave diathermy (MWD) with simultaneous skin cooling. Tissue temperatures were measured invasively by special thermistor probes designed to minimize MW-induced artifacts, and the local rates of MBF were measured by monitoring the radioactive washout of injected Xenon133 (Xe133). The experimental results have shown that the initial MBF response is characterized by a "critical temperature" behavior such that rapid increases in MBF occur for tissues above approximately 42C when diathermy power is sufficient. A proportionality between tissue temperature and MBF has not been found. To provide more useful descriptions of the temperature fields and diathermic BF responses, two-dimensional numerical thermal simulations of six of the subjects' treatments were constructed and recorded. An average peak simulated MBF of 48ml/min-100g was found for these subjects, a level in excess of previous estimates for maximum perfusion during diathermy.

Body Temperature↗
PubMed2003

A randomized, controlled trial of diathermy hemorrhoidectomy vs. stapled hemorrhoidectomy in an intended day-care setting with longer-term follow-up.

PURPOSE: Hemorrhoidectomy is the most effective long-term treatment for hemorrhoids. Although it is possible to perform hemorrhoidectomy as a day case with a high degree of patient satisfaction, patients take an average of 14 days off work after surgery. Stapled hemorrhoidectomy is believed to be less painful than conventional hemorrhoidectomy and should allow an earlier return to work. The aim of this study was to compare both the immediate and the long-term results of stapled hemorrhoidectomy with diathermy hemorrhoidectomy in patients with prolapsing internal hemorrhoids in an intended day-care setting. METHODS: Thirty-one patients were randomly assigned to undergo diathermy hemorrhoidectomy (n = 16) or stapled hemorrhoidectomy performed with a purpose-designed endoluminal stapling device, PPH01T (n = 15). All operations were planned as day or short-stay cases. All patients received lactulose, commenced preoperatively, together with postoperative topical glyceryl trinitrate and oral metronidazole. Patients were assessed by structured interview to assess their symptoms before and after surgery, with an intended follow-up of six months. All patients completed a 10-cm visual analog pain scale daily for the first ten days after surgery. RESULTS: The total pain score (sum of all pain scores) was significantly higher in the diathermy group (50 (range, 9.8-79.9) vs. 19.6 (range, 1.3-89.5), P = 0.03). Patients took a median of 14 (range, 3-21) days off work after diathermy hemorrhoidectomy compared with 10 (range, 3-38) days for the patients undergoing stapled hemorrhoidectomy (P = 0.15). At long-term follow-up, three patients (all in the stapled group) developed new symptoms of fecal urgency and anal pain, and three patients required further surgery to remove symptomatic external hemorrhoids after stapled hemorrhoidectomy. CONCLUSIONS: Although stapled hemorrhoidectomy is less painful in the short term, this does not lead to a significantly earlier return to work, and some patients develop new symptoms at long-term follow-up.

Adult↗
PubMed2003

Randomized, clinical trial of Ligasure vs conventional diathermy in hemorrhoidectomy.

PURPOSE: Hemorrhoidectomy is frequently associated with significant postoperative pain, and new techniques to reduce this pain are constantly under evaluation. The present study was conducted to determine the usefulness of the Ligasure system and compare it with conventional diathermy for hemorrhoidectomy. METHODS: Thirty-four consecutive patients with Grade 3 or 4 hemorrhoids requiring surgery were recruited and randomized into two groups by preoperative assignment of sealed envelopes. Patients with coexisting perianal disease, previous perianal surgery, or thrombosed hemorrhoids were excluded. All patients were anesthetized and operated on by a single team. In one group, monopolar diathermy in the coagulation mode was used to dissect hemorrhoidal tissue from the internal sphincter. In the second group, tissue was coagulated by Ligasure and then divided with scissors. Operating time was documented by theater staff. Postoperatively, pain scores and Cleveland Clinic incontinence scores were documented. RESULTS: Seventeen patients were randomized into each group. There were no significant differences in age, gender, or clinical symptoms between the groups. The mean operating time in the Ligasure group was 6 (range, 4-10) minutes compared with 11 (range, 7-20) minutes in the other group, and this was statistically significant (P < 0.001). Patients in the Ligasure group reported significantly less pain with first defecation and at postoperative Days 1 and 14 (P < 0.001). The mean hospital stay in both groups was one (range, 1-5) day, and there was no difference in the incontinence scores. CONCLUSIONS: Ligasure diathermy provides a superior alternative to conventional diathermy in hemorrhoidectomy by reducing operating time and postoperative pain.

Electrocoagulation↗
PubMed1997

Radiofrequency diathermy capsulorhexis of the anterior and posterior capsules in pediatric cataract surgery: preliminary results.

PURPOSE: To assess the effectiveness of radiofrequency diathermy capsulorhexis in preventing opacification of the posterior capsule in pediatric cataract extraction. SETTING: The Children's Hospital, Dublin, Ireland. METHODS: Radiofrequency diathermy capsulorhexis to the anterior capsule followed by injection of sodium hyaluronate behind the posterior capsule and primary posterior capsule diathermy capsulorhexis were performed in 14 eyes of 7 children requiring cataract surgery. RESULTS: Six patients had bilateral congenital and 1 patient bilateral developmental cataracts. Ten eyes (5 patients) received heparin-surface-modified intraocular lenses, and 4 eyes (2 patients) were left aphakic. There were no intraoperative complications, and only mild anterior segment inflammation was noted postoperatively. CONCLUSION: With follow-up from 7 to 16 months (mean 12.1 months), our results showed no epithelial regrowth or opacification of the posterior capsule following diathermy capsulorhexis.

Cataract↗
PubMed1990

Diathermy haemostasis at tonsillectomy: current practice--a survey of U.K. otolaryngologists.

The use of diathermy in achieving haemostasis at tonsillectomy was assessed by means of a postal questionnaire sent to consultant otolaryngologists practising in the U.K. A response of 81 per cent was obtained. Forty-four per cent presently use diathermy. Few considered the age of the patient or a history of a quinsy a contraindication to its use. The diathermy experience of users and non-users with regard to speed, post-operative pain and haemorrhage differs markedly. This dichotomy of opinions is confirmed by a review of the literature. Clearly there is a need for further studies to clarify the role of diathermy in tonsillectomy.

Adult↗
PubMed1993

A study of haemostasis following tonsillectomy comparing ligatures with diathermy.

The use of diathermy to achieve haemostasis after tonsillectomy remains controversial. We have reviewed the English language literature, and found no convicting evidence that diathermy is any more likely to cause post-operative haemorrhage than the use of ligatures. The results of a prospective, randomized study of 1036 consecutive tonsillectomies are presented. No significant difference was found in post-operative haemorrhage rates when either diathermy or ligatures were used. Diathermy was found to reduce operating time compared to ligatures. The possibilities for day-case tonsillectomy are discussed.

Adolescent↗
PubMed2004

An economic evaluation of laparoscopic ovarian diathermy versus gonadotrophin therapy for women with clomiphene citrate resistant polycystic ovary syndrome.

BACKGROUND: Laparoscopic ovarian diathermy and gonadotrophin ovulation induction for women with clomiphene citrate resistant polycystic ovary syndrome have been shown to result in similar pregnancy rates, but their relative cost-effectiveness has not been evaluated. METHODS: A cost-minimization study was undertaken alongside a randomized controlled trial in women with anovulatory infertility secondary to clomiphene resistant polycystic ovary syndrome. Inclusion criteria were age less than 39 years, body mass index less than 35 kg/m(2), failure to ovulate with 150 mg of clomiphene citrate for 5 days in the early follicular phase, more than 12 months of infertility and no other causes of infertility. Laparoscopic ovarian diathermy was compared with three cycles of urinary or recombinant gonadotrophins. Direct and indirect costs were based on the results of a randomized trial. RESULTS: The cost of a live birth was one third lower in the group that underwent laparoscopic ovarian diathermy compared to those women who received gonadotrophins (19 640 New Zealand dollars and 29 836 New Zealand dollars, respectively). CONCLUSIONS: This economic evaluation shows that treating women with clomiphene-resistant polycystic ovarian syndrome with laparoscopic ovarian diathermy results in a significant reduction in both direct and indirect costs.

Adult↗
PubMed2001

Pediatric adenoidectomy under vision using suction-diathermy ablation.

OBJECTIVES: To compare adenoidectomy using suction-diathermy ablation with adenoidectomy by way of curettage in a pediatric tertiary care setting. STUDY DESIGN: A prospective series of 68 children undergoing adenoidectomy (without tonsillectomy) under vision using a suction-diathermy ablation technique over 2 years was compared with an historical control group of 58 children undergoing adenoidectomy (without tonsillectomy) by way of curettage over 2 years. METHOD: Intraoperative blood loss was recorded and compared. Efficacy in improving nasal symptomatology was compared between the two groups using an ordinal "nasal symptom score" preoperatively and postoperatively. Complications were recorded and compared. Analysis was performed using two-tailed t tests. RESULTS: The two groups were well matched for age, weight, and adenoid size (P > .4). Follow-up ranged from 4 to 48 months. Adenoidectomy using suction-diathermy resulted in significantly less blood loss (P < .001). The technique was no less efficacious in terms of reducing the nasal symptom score than conventional adenoidectomy by way of curettage (P = .07). Complication rates were no different. No recurrences were identified and no instances of nasopharyngeal stenosis were recognized. CONCLUSIONS: Routine use of suction-diathermy ablation for adenoidectomy converts a difficult, often bloody procedure into a surgically precise operation. It is especially applicable to children. It may have additional advantages in aiding the prevention of the spread of the human form of bovine spongiform encephalopathy (variant Creutzfeldt-Jakob disease [CJD]). Compared with other recently introduced techniques for adenoidectomy, it is considerably less expensive.

Adenoidectomy↗
PubMed1987

Vitrectomy, scleral buckling, and peripheral diathermy treatment for severe proliferative vitreoretinopathy.

Transvitreal diathermy was combined with vitrectomy, scleral buckling, and silicone oil injection to treat 28 eyes with severe proliferative vitreoretinopathy and fore-shortened peripheral retina. A special gold tip on the diathermy probe prevented adhesions to the retina. The probe can be used for coaxial bipolar diathermy or for internal-external bipolar diathermy when combined with an electrode on the external scleral surface. Nineteen (68%) of 28 eyes treated with these methods achieved anatomic success and 10 eyes obtained final visual acuity ranging from 5/200 to 20/70.

Combined Modality Therapy↗
PubMed2002

Loop diathermy excision compared with cervical laser vaporisation for the treatment of intraepithelial neoplasia: a randomised controlled trial.

OBJECTIVE: To determine whether loop diathermy excision of the transformation zone and laser vaporisation are equally effective in the treatment of cervical intraepithelial neoplasia. DESIGN: Randomised controlled trial. POPULATION: Women referred for evaluation of cytological abnormality who were considered suitable for outpatient local destructive treatment. SETTING: Seven colposcopy units in the North West Region. METHODS: Loop diathermy excision of the transformation zone and laser vaporisation. MAIN OUTCOME MEASURE: Smear reported as moderate dyskariosis or worse following treatment. RESULTS: Of 289 women randomised, 285 had one or more smears following treatment. Women were more likely to have a smear reported as moderate dyskariosis or worse following laser vaporisation [hazard ratio 3.01 (95% CI 1.27 to 7.12)]. The cumulative risk of a smear reported as moderate dyskariosis or worse was 6.0% at six months and 12.1% at three years in those allocated laser vaporisation, and 2.0% at six months, and 3.3% at three years in those allocated loop diathermy excision of the transformation zone. CONCLUSIONS: Loop diathermy excision is a more effective treatment of cervical intraepithelial neoplasia than laser vaporisation.

Adult↗
PubMed2005

Efficacy of pressure topical anaesthesia in punctal occlusion by diathermy.

AIMS: To prospectively compare the efficacy and safety of pressure topical anaesthesia in punctal occlusion by using cautery in the treatment of dry eye syndrome (DES) with that of conventional treatment by using needle injection of anaesthetic agents. METHODS: In a randomised controlled trial, 18 consecutive adult patients with DES requiring punctal occlusion were recruited over a 10 month period. Consenting patients were randomised into two groups. Group A patients received pressure topical anaesthesia in the right eye followed by injection anaesthesia in the left eye. Group B was vice versa. Punctal occlusion using cautery was performed in each eye after a specified time following the application of anaesthesia. The main outcome measures were the pain experienced during application of anaesthesia and that during punctal occlusion. RESULTS: 36 eyes of 18 patients were randomised to receive injection anaesthesia in one eye and pressure topical anaesthesia in the other. Nine patients (nine females) were in group A and nine patients (seven females, two males) in group B. The mean age of group A patients was 45.3 (SD 13.5) years, and that of group B patients was 55.6 (12.6) years. The two groups were comparable in terms of mean age (p=0.117) and mean pain score for pressure topical anaesthesia application (p=0.612), injection anaesthesia application (p=0.454), diathermy in pressure anaesthetised eyes (p=0.113), and diathermy in injection anaesthetised eyes (p=0.289). Paired t test was used to compare the mean pain score for pressure topical anaesthesia application (16.8 (24.8)) with those for injection anaesthesia application (56.7 (30.0)). 18 eyes of 18 patients were compared with the fellow eye of the same 18 patients. The mean pain score for injection anaesthesia was greater than for pressure topical anaesthesia application (p<0.0001) (statistical power=0.87). No statistically significant difference was found in the mean pain score for diathermy for eyes that received pressure topical anaesthesia (20.5 (27.5)) compared with eyes that received injection anaesthesia (23.1 (26.3)) (p=0.760) (statistical power=0.96). All 18 patients preferred pressure topical anaesthesia to injection anaesthesia. CONCLUSION: Injection anaesthesia for punctal occlusion is more painful than pressure topical anaesthesia application. However, the pain experienced during diathermy application for punctal occlusion is similar between pressure anaesthetised eyes and injection anaesthetised eyes. Pressure topical anaesthesia is a less painful (in terms of anaesthesia application) but equally effective alternative to conventional injection anaesthesia when used for punctal occlusion.

Adult↗
PubMedDate not supplied

Evaluation report: surgical diathermy units.

A recent issue of 'Health Equipment Information' (No. 122, April 1984) contains evaluation reports on three surgical diathermy units: the Downs Diadon 170, the Martin Elektrotom 500B, and the Olympus PSD-2. In addition to the detailed evaluation reports, 'HEI' 122 also contained a glossary of terms associated with these devices, and a summary of a discussion on the safety of surgical diathermy units presented in a fuller form in 'HEI' 99. A review of the principles and practice of surgical diathermy has recently been published in 'Journal of Medical Engineering & Technology'. Technical aspects of the equipment have been assessed against BS 5724 Part 1, which is the British version of IEC Publication 601-1, in conjunction with a particular standard for surgical diathermy units, IEC 601-2-2, which modifies the general standard. The protocol for the user trials was devised jointly by DHSS, together with local physics staff and surgeons. Orders for 'HEI' 122 (f3.00) to DHSS Leaflets Unit, PO Box 21, Stanmore, Middlesex HA7 1AY, UK. NHS staff can obtain it, free, through their Administrator. For full details of the evaluation findings, readers should consult 'HEI' 122: the following are extracts from the report.

Electrocoagulation↗
PubMed2000

Are surgeons aware of the dangers of diathermy?

Surgical diathermy is an invaluable aid in modern surgery and most contemporary diathermy machines are considered safe. However, diathermy accidents still do occur and a diathermy unit can be potentially lethal if adequate care is not exercised in its use.

Awareness↗
PubMed2000

Are surgeons aware of the dangers of diathermy?

Surgical diathermy is an invaluable aid in modern surgery and most contemporary diathermy machines are considered safe. However, diathermy accidents do still occur and a diathermy unit can be potentially lethal if adequate care is not exercised in its use.

Burns, Electric↗
PubMed1976

An experimental study of gastric healing following scalpel and diathermy incisions.

To date there has been no reliable information available which compares gastric healing following incisions made by scalpel and diathermy. Standard incisions were made in rat stomachs, half with a scalpel and half with diathermy, following which they were closed in a standard fashion. Healing was assessed at intervals by bursting and tensile strength measurements, angiography, and histology. All incisions were healed by the tenth day. The only significant difference discovered was that histologically there was a definite lag in healing up to the fifth day in those incisions made by diathermy. It is suspected that this is due to mucosa having been dragged into the wound edges by adherence to the diathermy knife.

Animals↗
PubMed2006

Effects of repetitive shortwave diathermy for reducing synovitis in patients with knee osteoarthritis: an ultrasonographic study.

BACKGROUND AND PURPOSE: Shortwave (SW) diathermy can be used to improve vascular circulation and reduce inflammation and pain for patients with osteoarthritis. However, reduction in synovial inflammation has never been explored. The purpose of this study was to investigate whether repetitive SW diathermy, using ultrasonographic examination, could reduce synovitis in patients with knee osteoarthritis. SUBJECTS AND METHODS: Thirty subjects with 44 osteoarthritic knees participated in this study. Eleven subjects received SW, and 10 subjects received SW and nonsteroidal anti-inflammatory drugs. Nine subjects received no treatment and served as a control group. Synovial sac thickness superior, medial, and lateral to the patella was measured using ultrasonography. The sum of these 3 measurements was taken as the total synovial sac thickness. Subjects in the treatment groups underwent ultrasonographic examination before and after 10, 20, and 30 treatments, whereas control subjects underwent ultrasonographic examination before the experiment and then once every 2 or 3 weeks for a total of 3 follow-up measurements. RESULTS: After 10 SW diathermy treatments, the total synovial sac thickness in both treatment groups was significantly less than the initial thickness, and the synovial sac continued to become significantly thinner with 20 sessions of treatment. These observations were not made in the control subjects. DISCUSSION AND CONCLUSION: The results indicate that SW diathermy in patients with knee osteoarthritis can significantly reduce both synovial thickness and knee pain. Such reductions of synovial sac thickness and pain index continue over treatment sessions.

Aged↗