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At least 91 records · Page 5Linked to original sources
PubMed1996

The mechanical properties of the human lens capsule following capsulorhexis or radiofrequency diathermy capsulotomy.

OBJECTIVE: To quantify the biomechanical properties of the capsulotomy edge following continuous-tear circular capsulorhexis (CTCC) or radiofrequency (RF) diathermy capsulotomy. METHODS: A test apparatus was constructed that allowed controlled stretching of capsulotomy edges following CTCC or RF diathermy capsulotomy. The lens contents were removed by phacoemulsification to permit the implantation of probes that exerted a test force on the capsulotomy edge and were moved in diametrically opposite directions using computer-controlled stepping motors. The magnitude of the force was measured during the capsule stretch, which allowed precise determination of the degree of capsular distention at the time of capsular rupture. Selected capsular edges were subsequently examined by scanning electron microscopy. RESULTS: The capsulotomy edge produced by CTCC was significantly stronger (P < .001) than that following RF. The mean (+/-SD) force to achieve capsule rupture was 0.15 +/- 0.06 N with CTCC compared with 0.02 +/- 0.01 N with RF. The mean (+/-SD) increase in the capsulotomy circumference was significantly greater with CTCC at 53% +/- 14.5% compared with RF at 18% +/- 8.5% (P < .001). Scanning electron microscopy disclosed a smooth edge for the CTCC capsulotomy. In contrast, multiple irregularities were seen in the edge following RF. CONCLUSIONS: Continuous-tear circular capsulorhexis provides a stronger capsulotomy and is the preferred method in routine cataract surgery. However, RF diathermy capsulotomy may have a useful role in conditions unfavorable to the safe completion of CTCC.

Biomechanical Phenomena↗
PubMed2004

Use of a diathermy system in thyroid surgery.

HYPOTHESIS: New hemostatic methods have been widely used in open and laparoscopic surgery. The LigaSure Precise diathermy system (Valleylab, Boulder, Colo) has been recently used in thyroid surgery. We hypothesized that its use could lead to reduced operative time and fewer complications compared with conventional knot tying in total or near-total thyroidectomy. DESIGN: Prospective case-controlled study. SETTING: Tertiary care private hospital. PATIENTS: Eighty patients underwent total or near-total thyroidectomy by 1 surgeon. INTERVENTIONS: Forty patients underwent thyroidectomy with the conventional knot tying technique and 40 patients with the LigaSure diathermy system. MAIN OUTCOME MEASURES: Demographics, histopathological diagnosis, operative time, intraoperative blood loss, complications, and cost, using chi2 test and Wilcoxon rank sum test. RESULTS: The study groups had similar demographic and histopathological characteristics. The mean +/- SD operative time was nonsignificantly reduced in the LigaSure group compared with the conventional knot tying group (84 +/- 6 vs 89 +/- 7 minutes, P = .60). The mean +/- SD intraoperative blood loss was less for the LigaSure group (30 +/- 5 vs 35 +/- 8 mL, P = .36). There was 1 case of transient recurrent laryngeal nerve palsy in the LigaSure group. One patient from this group and 2 patients from the other group exhibited transient hypocalcemia; permanent postoperative hypocalcemia was not encountered in either group. The cost of the LigaSure diathermy system was significantly greater than that of conventional knot tying. CONCLUSION: Use of the LigaSure in thyroid surgery did not significantly reduce operative time, blood loss, or complication rates compared with conventional knot tying, but it increased operative cost.

Case-Control Studies↗
PubMed2002

Ultrasound-guided umbilical cord occlusion using bipolar diathermy for Stage III/IV twin-twin transfusion syndrome.

OBJECTIVES: To evaluate bipolar diathermy as a technique for selective fetocide in the treatment of advanced (Stage III/IV) twin-twin transfusion syndrome (TTTS). METHODS: A prospective observational study in two tertiary referral fetal medicine centres: Queen Charlotte's Hospital, London, UK and Haemek Hospital, Afula, Israel. Fifteen cases of TTTS (14 twins and one triplet pregnancy) were treated by selective occlusion of either the donor (n=8) or recipient's (n=7) umbilical cord using ultrasound-guided bipolar diathermy. Following each procedure, patients were scanned serially for fetal growth, liquor volume and umbilical Doppler measurements. Procedural complications and obstetric outcome were recorded. Postnatal placental injection studies were performed. RESULTS: Overall co-twin survival in Stage III/IV TTTS was 13/14 (93%). There were no treatment failures. The incidence of preterm prelabour rupture of membranes (PPROM) within 3 weeks of the procedure was 3/15 (20%). In those cases where pre-procedure umbilical artery Dopplers were abnormal, the Doppler findings normalised post-procedure in all non-cord-occluded fetuses. Growth velocities of surviving donors were similar to those of surviving recipients. CONCLUSIONS: Bipolar diathermy appears an effective technique for the selective reduction of monochorionic twins complicated by severe as well as preterminal TTTS, with recipient and donor fetuses being equally appropriate choices for fetocide. We suggest that for advanced-stage disease where the parents can contemplate this option, cord occlusion as a single preemptive procedure maximises the opportunity for intact survival of a single survivor.

Diathermy↗
PubMed1993

A comparison between loop diathermy conization and cold-knife conization for management of cervical dysplasia associated with unsatisfactory colposcopy.

Eighty-six women with cervical dysplasia and unsatisfactory colposcopy were managed with excisional conization--43 with outpatient loop diathermy conization under local anesthesia and 43 matched controls with cold-knife conization as inpatients under general anesthesia. Both groups were similar in terms of age, parity, and severity of dyskaryosis on initial cytology, treatment success rates, and completeness of excision. However, loop diathermy conization was significantly quicker (2.8 +/- 2.9 min vs 14 +/- 18.6 min) and associated with less intraoperative blood loss (3.3 +/- 2.8 ml vs 79.1 +/- 74.6 ml) (P < 0.01) than cold-knife conization. Furthermore, the proportion of women with at least one complication was significantly less following loop (4.7%) than cold-knife conization (20.9%) (P < 0.05). We conclude that outpatient loop diathermy conization performed under local anesthesia is quicker and causes less intraoperative blood loss and immediate postoperative complications than cold-knife conization for management of cervical dysplasia associated with unsatisfactory colposcopy.

Adult↗
PubMed1998

Prospective, randomized trial comparing pain and complications between diathermy and scissors for closed hemorrhoidectomy.

PURPOSE: The aim of this study was to assess pain and complication rates after closed hemorrhoidectomy with the use of either scissors or diathermy excision. METHODS: Ninety-one consecutive patients were prospectively randomly assigned by use of sealed envelopes to Group A (diathermy dissection; n = 44) or Group B (scissors dissection; n = 47). The resulting hemorrhoidal pedicle after hemorrhoidal dissection was transfixed and buried under the mucosa, which was closed with 3-0 chromic catgut. RESULTS: The median time taken for surgery was ten minutes in both groups. The range for Group A was 5 to 25 minutes, and the range for Group B was 5 to 20 minutes. There were no statistically significant differences in the pain scores between the two groups for any of the seven postoperative days studied. The median number of pethidine injections in Group A was 1 and in Group B was 0 (P < 0.009). The number of oral analgesic tablets used was 8 (range, 4-10) and 14 (range, 0-10) for Groups A and B, respectively (P < 0.001). The number of tubes of topical lignocaine jelly used was 14 (range, 0-22) and 14 (range, 7-88) in Groups A and B, respectively. Two patients in each group developed secondary hemorrhage, but no patient had anal stricturing. CONCLUSION: No excessive complications are seen with closed hemorrhoidectomy, and diathermy seems to require less postoperative analgesic medicine than scissors for closed hemorrhoidectomy except in the first 24 hours.

Adult↗
PubMed1994

Pseudoinvasion of vascular spaces: report of an artifact caused by cervical lidocaine injection prior to loop diathermy.

Cervical loop diathermy is a relatively new procedure performed by gynecologists to diagnose and treat squamous intraepithelial lesions. We report a case of pseudoinvasion of vascular spaces noted in an excisional biopsy of a high-grade squamous intraepithelial lesion of the cervix. The neoplastic epithelium was forced into the cervical stroma by injection of local anesthetic through the lesion prior to loop diathermy. The identification of this pseudovascular space invasion as artifact had important prognostic and therapeutic value. With the increasing use of loop diathermy and local anesthesia this type of artifact may be seen more commonly.

Adult↗
PubMed2002

Randomized clinical trial of stapled haemorrhoidopexy versus conventional diathermy haemorrhoidectomy.

BACKGROUND: The aim of this study was to compare the results of stapled haemorrhoidopexy (commonly called stapled haemorrhoidectomy) with those of conventional diathermy haemorrhoidectomy. METHODS: Fifty-five patients with symptomatic third- and fourth-degree haemorrhoids were randomized to either stapled haemorrhoidopexy (n = 27) or conventional diathermy haemorrhoid ectomy (n = 28). Operating time, postoperative pain, time to return to work, postoperative complications and effectiveness of haemorrhoidal symptom control were recorded. The mean follow-up was 15.9 months in the stapled haemorrhoidopexy group and 15.2 months in the conventional haemorrhoidectomy group. RESULTS: Mean pain intensity was significantly less in the stapled group (P = 0.001). There were no significant differences in the total number of complications, the length of absence from work or control of symptoms. Seven patients in the stapled group re-presented with prolapse compared with none in the conventional haemorrhoidectomy group (P = 0.004). This difference was also observed in the subset of patients with fourth-degree haemorrhoids (P = 0.003). CONCLUSION: The stapled operation was significantly less painful than conventional haemorrhoidectomy. However, the rate of recurrent prolapse was higher after stapled haemorrhoidopexy than after conventional diathermy haemorrhoidectomy.

Diathermy↗
PubMed1997

Hyperaemia evaluation in clinical diathermy by four-electrode impedance measurements.

The four-electrode electrical impedance measurement technique is proposed for the evaluation of the hyperaemia variation in tissues treated by diathermic therapy. An impedance meter suitable for such measurements is described, and an electrical model of the heated tissues, concerning the impedance variation during diathermy and its relation with hyperaemia, is presented. The occurrence of the substantial contribution of blood to the overall transverse impedance is demonstrated by comparing the experimental results with those arising from a 2D electrical/thermal model of the treated tissues. A two-admittance model is proposed to explain the electrical behaviour of the tissues treated by diathermy. The model allows us to separate the impedance violation due to the temperature dependence of tissue conductivity from that due to the change of tissue blood content. The results of preliminary measurements of tissue impedance on healthy volunteers treated by electromagnetic diathermy are presented and discussed, showing the feasibility of impedance detection of hyperaemia variations inside tissues.

Body Temperature↗
PubMed1994

An evaluation of safe practices to restrict exposure to electric and magnetic fields from therapeutic and surgical diathermy equipment.

Stray electric and magnetic fields have been measured near to therapeutic and surgical diathermy equipment for many different treatments. The highest field strengths are associated with continuous wave (cw) 27 MHz therapeutic diathermy equipment for which fields above national reference levels extend for 1 m from the electrodes and cables. The extent of the fields does not vary substantially with the type of treatment being performed. Recommendations that operators remain 1.0 m from cw therapeutic diathermy equipment, 0.5-0.8 m from pulsed treatments with capacitive electrodes and 0.2 m from pulsed inductive applicators can be applied to restrict exposure for any treatment with each type of unit. In a proposed European Community (EC) directive, action levels similar in magnitude to the reference levels are used to trigger requirements for assessments of hazard, measures to reduce exposure and personnel training. Assessments and appropriate recommendations of measures to reduce exposure can be linked to the type of equipment. Fields associated with electrosurgical units operating at frequencies of 0.3-0.5 MHz only approached reference levels within 20-30 cm of the cables, and because of the relatively short durations of the emissions, precautions were considered unnecessary with the units tested.

Diathermy↗
PubMed1982

Exposure to the operator and patient during short wave diathermy treatments.

Short-wave diathermy is one of the most popular treatment modalities used to relieve pain through localized heating. In Canada its use in hospitals is as frequent as that of ultrasonic therapy devices and about 10 times more popular than microwave diathermy. Intensities of the electric and magnetic fields around applicators of 7 different diathermy units were measured at the operator position and at various untreated areas of the patient during 11 treatment regimes using 5 types of applicators. Exposure to the operator in the normal operating position, behind the device console, usually does not exceed the limits recommended by the Canadian Federal Government. The intense fields around the applicators and the cables extend up to 0.5 m and are a source of potential overexposure to the operator.

Ambulatory Care Facilities↗
PubMed1992

Post-tonsillectomy pain with diathermy and ligation techniques. A prospective randomized study in children and adults.

150 patients (80 children and 70 adults) were entered into a prospective randomized study to compare the post-tonsillectomy pain of unipolar diathermy as opposed to ligation for haemostasis. In children, we found no difference in post-operative pain between the diathermy and ligation techniques. However, in adults there was a significant difference, more post-operative pain occurring with diathermy. There was no significant difference in the incidence of secondary haemorrhage.

Adolescent↗
PubMed1998

Do routine antibiotics after loop diathermy excision reduce morbidity?

OBJECTIVE: To evaluate whether routinely giving an antibiotic after loop diathermy excision of the cervical transformation zone reduced post-operative vaginal loss. DESIGN: Prospective, randomised, double-blind placebo controlled parallel study. PARTICIPANTS: Five hundred women undergoing loop diathermy excision in a colposcopy clinic. INTERVENTION: Administration of either ofloxacin 400 mg (2x200 mg) once daily for 5 days or an identical placebo. MAIN OUTCOME MEASURE: Vaginal loss, assessed using a pictorial chart. RESULTS: No significant difference in post-operative vaginal loss was found. CONCLUSION: Routine antibiotic prophylaxis after loop diathermy excision is not justified.

Adult↗
PubMed2006

How we do it: Transoral suction diathermy adenoid ablation under direct vision using a 45 degree endoscope.

Keypoints * Adenoid ablation using suction diathermy is associated with a number of difficulties, mainly associated with the use of the mirror. Transoral and transnasal 0 degree endoscopes have also been utilised but again have limitations. We describe a technique that overcomes the above problems. * A prospective case series of patients undergoing suction diathermy adenoidectomy under direct vision using a transoral 45 degree endoscope connected to a monitor was conducted, performed by surgical trainees and under direct supervision of the consultant trainer (J.R.-J.). * Intra-operatively, trainees had to demonstrate to the trainer the appropriate anatomy, completed adenoid ablation, and haemostasis. * Fifty-six cases have been performed. In every case, it was possible for the trainer to monitor the trainee's technique throughout the entire procedure. No complications have been reported. * We describe a modified technique which overcomes the disadvantages previously encountered by conventional suction diathermy adenoid ablation.

Adenoidectomy↗
PubMed1983

Liver regeneration after atypical hepatectomy in the rat. A comparison of CO2 laser with scalpel and electrical diathermy.

Rats were subjected to partial hepatic lobectomy with removal of about two thirds of the liver either by scalpel, by CO2 laser, or by electrical diathermy. Macroscopic examinations of livers at various days after surgery indicated that CO2 laser surgery results in minor tissue damage, reduced complications from inflammation and infections, and faster healing compared to electrical diathermy, but it is less satisfactory than the scalpel with respect to all these parameters. Rat liver regeneration was followed at the molecular level by measuring the changes of protein biosynthesis activity in the liver, as monitored by modifications of ribosome organization. Activation of the protein biosynthesis process started 1 day after surgery when hepatectomy was performed by scalpel, while 2 days were required when CO2 laser or electrical diathermy were used instead.

Animals↗
PubMed2003

A randomised trial of knife versus diathermy in pilonidal disease.

BACKGROUND: Pilonidal disease is a common debilitating condition. This prospective randomised study compared excision of pilonidal disease with a scalpel or diathermy with respect to operation time, postoperative pain, functional recovery and wound healing. PATIENTS AND METHODS: Patients undergoing surgery for pilonidal disease were randomised to excision by scalpel (group 1) or diathermy (group 2). Patients received regular peri-operative oral analgesia and a standardised general anaesthetic technique. Duration of operation was recorded. Following surgery, pain, analgesic requirements, sedation, nausea and vomiting scores and time to mobilise and time to complete healing were compared. RESULTS: Statistical significance between groups was obtained for five outcomes after 32 patients had been recruited; of these, 81% were admitted as emergencies with an abscess. The duration of surgery in group 2 was significantly less, postoperative pain scores and morphine requirements were lower and mobility was regained sooner. CONCLUSIONS: We advocate the use of diathermy needle rather than scalpel blade when undertaking excision of pilonidal disease in both acute and chronic patients.

Adolescent↗
PubMedDate not supplied

Reduction of radiofrequency exposure to the operator during short-wave diathermy treatments.

Radiofrequency electromagnetic fields near short-wave diathermy equipment operating at a frequency of 27.12 MHz can expose the physical therapist to levels above those recommended in standards for radiofrequency exposure in Western countries. Electric and magnetic fields around air-gap, diplode, monode and circuplode applicators were mapped by the author. Large differences in stray field intensities were found for the various applicators. The air-gap electrodes caused the highest levels of unwanted radiation, and the circuplode caused the lowest levels. The use of the circuplode would normally ensure an operator exposure far below the levels in recommended standards. In order to reduce the exposure during the first few minutes of a treatment, when air-gap electrodes or diplode are used, the operator should stand at the end of the diathermy console opposite to the applicator and cables and not, as is often the case, at one side. It is recommended that manufacturers change the design of the diathermy console (a minor modification) in order to ensure this operating position.

Diathermy↗
PubMed1999

Diathermy knife does not reduce bleeding in surgery for primary hip arthroplasty. A prospective randomized study of 67 patients.

We evaluated bleeding in a prospective randomized study of 67 patients undergoing primary hip arthroplasty. In group A, all dissections were made with the diathermy knife and in group B, we used the scalpel. In both groups, bleeding points were coagulated with diathermy. The surgical approach, use of anti-coagulants and method of anesthesia were similar in the two groups. We found that use of a diathermy knife does not significantly reduce bleeding.

Adult↗
PubMed2001

Upper dorsal thoracoscopic sympathectomy for palmar hyperhidrosis. The use of harmonic scalpel versus diathermy.

BACKGROUND: Upper dorsal thoracoscopic sympathectomy, the treatment of choice for primary palmar hyperhidrosis, is not devoid of long-term complications, like Horner's syndrome and postoperative neuralgia. It has been postulated that propagation of heat induced by diathermy may be responsible for some of these sequelae. To assess this hypothesis, a study was undertaken to evaluate the use of harmonic scalpel, which does not dissipate heat. METHOD: Sixteen patients with primary palmar hyperhidrosis underwent upper dorsal thoracoscopic sympathectomy using the harmonic scalpel on one side and diathermy on the other. Follow-up was made two years postoperatively. RESULTS: The length of the procedure with each instrument was similar. There was no localization of postoperative pain, which could be attributed to either device. No Horner's syndrome or postoperative neuralgia occurred. CONCLUSION: The present study proved the safe use of harmonic scalpel for upper dorsal thoracoscopic sympathectomy, but did not detect any important advantage of either instrument over diathermy.

Adolescent↗