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PubMed1975

Disturbances in the function of cardiac pacemaker caused by short wave and microwave diathermies and pulsed high frequency current.

The effect of short wave diathermy, pulsed high frequency current (Diapulse, Curapuls) and microwave diathermy on the function of an implantable cardiac pacemaker and its leads was examined by measuring the output (voltage) and rate of the pacemaker under various experimental conditions. It appeared that all these devices had a decreasing effect on the output and an increasing effect on the rate of the pacemaker. When therapeutic doses (power) were applied the greatest changes in output and rate were caused by microwave diathermy and the slightest by Curapuls. The clinical precautionary measures based on these observations are discussed.

Arrhythmias, Cardiac↗
PubMedDate not supplied

Corneal burn: a rare complication of radiofrequency diathermy capsulotomy.

We present 2 patients with accidental corneal burns inflicted during clear cornea cataract surgery using radiofrequency diathermy for anterior capsulotomy. During the capsulotomy procedure, the anterior capsule was not opened and only a small air bubble appeared when the energy was turned on. Meanwhile the area of the corneal tunnel that contacted the shoulder of the diathermy tip became opaque and shrank with a small defect in the anterior corneal lip. Postoperatively, focal corneal shrinkage with iris incarceration into the defect of the corneal tunnel and resultant peaking pupil were noted in the 2 patients. The corneal burns resulted in temporary irregular astigmatism with mild visual acuity impairment. To our knowledge, this is the first report of a corneal burn as a complication of radiofrequency diathermy for anterior capsulotomy in clear cornea cataract surgery.

Aged↗
PubMed2003

Laparoscopic ovarian drilling with diathermy in the treatment of infertile women with polycystic ovaries.

BACKGROUND: [corrected] To describe the effect of laparoscopic ovarian drilling with diathermy on the pregnancy outcome of infertile women with polycystic ovaries. METHODS: Between September 2000 and July 2001, 6 infertile patients with polycystic ovaries who visited the Kinmen County Hospital consented to participate in the study. Oligomenorrhea was the common clinical symptoms of these 6 patients whose pelvic sonogram revealed typical pattern of polycystic ovaries. All patients had been unresponsive to treatment with clomiphene citrate. Laparoscopic ovarian drilling with diathermy was performed. The rates of spontaneous ovulation and pregnancy were calculated. RESULTS: Four of the 6 patients (66.6%) resumed regular menstruation and 5 of the 6 patients (83.3%) were able to become pregnant within 6 months. The mean time to the first conception was 81 days (range 12 to 172 days); 1 of the 5 pregnancies ended with miscarriage at 8 weeks of gestational age. CONCLUSIONS: Laparoscopic ovarian drilling with diathermy can be an effective method for infertile women with ultrasonographic pattern of polycystic ovaries to achieve pregnancy.

Adult↗
PubMed1982

Shortwave diathermy effects on 35S-sulfate uptake and glycosaminoglycan concentration in rabbit knee tissue.

The effect of shortwave diathermy on glycosaminoglycan metabolism in different connective tissues of rabbit knee was studied by both autoradiography and radioactivity measurements and quantification of the separated glycosaminoglycans. Of 30 rabbits used, 12 received 100W shortwave diathermy to the right knee 10 minutes a day for 5 days. Autoradiography clearly showed a higher uptake of 35S-sulfate by the capsular tissues of the knee treated with shortwave diathermy than in the contralateral knee. The most prominent feature of the biochemical analysis was the increase in the galactosamine (43%) and glucosamine (26%) concentrations of the collateral ligament glycosaminoglycans of the treated knee.

Animals↗
PubMed1981

[Measurement and hygienic evaluation of electromagnetic fields in the environment of diathermy, welding machines and induction heaters].

Measurements of electromagnetic field intensity at work-stations, as well as in the environment of 36 induction heaters, 24 welders and 6 diathermies have been taken. Maximum values of field E intensity at the work-stations with induction heaters ranged from below 2 V/m to 96 V/m, and for field H -- from below 0.5 A/m to 8.2 A/m. Maximum values of field E intensity at the work-stations with welders ranged from 25 V/m to 480 V/m. And Maximum values of field E with diathermy exceeded 300 V/m near electrodes. At the work-station of medical staff operating diathermy, the field intensity values ranged from 5.1 to 16 V/m. Basing on the obtained values of the e-m intensity at work-stations and in the environment of the mentioned instruments, protective zones ranges have been determined: intermediate, weerning and dangerous. In addition, effective e-m field exposure duration, at specific instruments, has been determined.

Diathermy↗
PubMed2003

Prospective randomized study of bacteraemia in diathermy and stapled haemorrhoidectomy.

BACKGROUND: The incidence and consequences of bacteraemia associated with diathermy and stapled haemorrhoidectomy have not been studied previously. METHODS: Two hundred and five healthy patients randomized to stapled haemorrhoidectomy or diathermy haemorrhoidectomy had perioperative blood cultures taken. The clinical sequelae of bacteraemia and complications of surgery were assessed prospectively. RESULTS: Six patients were excluded for protocol violations. Eleven (11 per cent) of 101 patients with stapled and five (5 per cent) of 98 who had diathermy haemorrhoidectomy had positive blood cultures for organisms after haemorrhoidectomy, predominantly anaerobes commonly found within the bacterial flora of the anorectum (P = 0.19). Transient postoperative pyrexia in several patients did not correlate with detected bacteraemia and settled spontaneously without treatment. There were no serious complications from either operative technique, and no clinical consequences from proven bacteraemia. CONCLUSION: Transient bacteraemia may complicate surgical haemorrhoidectomy but has no serious clinical consequences for healthy adults.

Adult↗
PubMed1990

Anastomosis of biliary tissue with high-frequency electrical diathermy.

Laser tissue fusion results from the conversion of light to thermal energy, creating tissue heating and protein denaturation. Accurately controlled tissue heating from smaller, less expensive, non-laser sources should be able to duplicate the fusion or welding of tissues, which has been demonstrated with a variety of lasers. We examined the capability of high-frequency electrical diathermy to create effective tissue fusion with limited collateral thermal damage. Using an electrical diathermy device with up to 14 W output power at 13.56 MHz, the cystic ducts of freshly harvested canine gallbladders were fused shut. Immediately after closure of the cystic ducts, bursting pressure was determined. Welding time was approximately 60 s. Mean bursting strengths immediately after closure were 207 mm Hg (+/- 94.3) in air (n = 10) and 202 mm Hg (+/- 44.7) under water immersion (n = 9). Histologic sectioning revealed a full-thickness denaturation of collagen fibers with fusion. Our preliminary investigations suggest that high-frequency electrical diathermy may provide practical advantages for fusion of biliary tissues when compared with conventional suture closure and laser fusion.

Anastomosis, Surgical↗
PubMed1990

A randomized trial comparing direct current therapy and bipolar diathermy in the outpatient treatment of third-degree hemorrhoids.

Fifty patients with third-degree hemorrhoids were randomized to receive outpatient treatment with either bipolar diathermy or direct current therapy. Direct current therapy was used to treat 26 patients and bipolar diathermy was used to treat 24 patients. Twenty patients in each group were successfully treated as judged by resolution of symptoms and shrinkage of hemorrhoidal tissue. Both treatments are effective in the outpatient management of large, prolapsing hemorrhoids. Bipolar diathermy is less time consuming and better tolerated.

Ambulatory Surgical Procedures↗
PubMed2001

Prospective, randomized trial comparing diathermy and Harmonic Scalpel hemorrhoidectomy.

PURPOSE: The aim of this study was to compare diathermy and Harmonic Scalpel hemorrhoidectomy. METHODS: Fifty consecutive patients were randomly assigned to 2 groups: Group 1 (diathermy) and Group 2 (Harmonic Scalpel). RESULTS: The median duration of surgery was 10 minutes for both groups. The median number of pethidine injections used for both groups was zero. The median number of oral analgesic tablets taken was 13 by Group 1 and 14 by Group 2 patients. The median number of tubes of lidocaine jelly used was two by Group 1 and three by Group 2. There was no statistical difference between pain scores recorded by both groups. Five patients in Group 1 developed posthemorrhoidectomy bleed vs. one patient in Group 2 (P = NS). CONCLUSION: Hemorrhoidectomy by Harmonic Scalpel is comparable to diathermy hemorrhoidectomy in terms of postoperative pain and complications.

Adult↗
PubMed2002

Randomised trial comparing LigaSure haemorrhoidectomy with the diathermy dissection operation.

The study was designed to compare LigaSure haemorrhoidectomy with open haemorrhoidectomy performed by means of diathermy excision. Fifty-sixty consecutive patients with third- and fourth-degree haemorrhoids were randomly allocated to undergo either LigaSure haemorrhoidectomy (29 patients) or diathermy haemorrhoidectomy (27 patients). All patients were evaluated for operative time, pain, post-operative analgesic requirements, time to first bowel movement, length of hospital stay, wound healing period, time to return to work, and occurrence of early postoperative complications (such as urinary dysfunction, bleeding, soiling, seepage, continence disorders) and late complications (such as stenosis). A statistically significant advantage was observed in the patients who received the LigaSure technique as far as concerns length of operative time (9.2 vs. 12.2 min, p<0.001), post-operative analgesic requirements (14.1 vs. 16.8 administrations, p<0.001), wound healing period (16.3 vs. 37.5 days, p< 0.0001), and time to return to work (8.3 vs. 18.3 days, p<0.01). No significant difference was seen in the postoperative pain score, complications rate, first bowel motion or hospital stay. No recurrence was observed at the 6-month follow-up. In conclusion, our experience shows that the LigaSure haemorrhoidectomy offers definite advantages over the classic diathermy technique. This procedure is easier, safer, and more rapid to perform and is followed by a faster wound healing time, a significantly shorter hospital stay, less postoperative pain and faster wound healing.

Adult↗
PubMed1990

Treatment of cervical intraepithelial neoplasia: experience with the low-voltage diathermy loop.

Eighty patients with cervical abnormalities that were proved by colposcopy were treated with the low-voltage diathermy loop by excision biopsy of isolated lesions (n = 14), excision of the transformation zone (n = 52), or by cone biopsy (n = 14). Treatment was performed at the time of initial assessment with the patient under a local anesthetic. Treatment proved acceptable to patients and minimal discomfort was reported. Primary hemorrhage was not a problem, although secondary hemorrhage occurred in 3.7% of patients. Excision was histologically complete in 85% of cases, and excision was clinically complete in the remaining cases. Diathermy coagulation to the base of the lesion ensured hemostasis and destroyed any residual cervical intraepithelial neoplasia. Follow-up cytologic findings were normal in 91% of patients at 3 months, and colposcopy showed no abnormality in 95% of patients at 6 months. The squamocolumnar junction was fully visible in 91% of patients. Thus excisional techniques with the low-voltage diathermy loop appear to be a viable treatment option for cervical intraepithelial neoplasia.

Anesthesia, Local↗
PubMed1993

Outpatient excisional management of cervical intraepithelial neoplasia. A prospective, randomized comparison between loop diathermy excision and laser excisional conization.

OBJECTIVE: The purpose of our study was to compare loop diathermy excision and laser excisional conization with respect to treatment time, reliability, effectiveness, and safety. STUDY DESIGN: Three hundred women with cervical intraepithelial neoplasia attending our colposcopy clinic were randomized to treatment with either loop diathermy excision (group 1, n = 150) or carbon dioxide laser excisional conization (group 2, n = 150), both performed with local anesthesia on an outpatient basis. Student's t or Mann-Whitney test were used to compare continuous data; the chi 2 test was used for categoric data. RESULTS: The mean age, parity, histologic features, depth of excision, and occurrence of residual or recurrent disease were similar; however, the mean time required to complete treatment and hemostasis (2.5 +/- 3.6 vs 24.2 +/- 11.8 min), patient discomfort, blood loss (2.77 +/- 3.76 vs 27.15 +/- 17.51 ml; p < 0.001), and considerable thermal artifact affecting histologic interpretation of excision margins (5 cases vs 25 cases; p < 0.01) were significantly less in group 1 than in group 2. CONCLUSION: In our experience outpatient loop diathermy excision is an equally effective, quicker, safer, and more reliable excisional technique than laser excisional conization.

Adult↗
PubMed1996

Post-tonsillectomy pain with selective diathermy haemostasis.

A prospective randomized study was carried out to assess the post-tonsillectomy morbidity of the selective diathermy technique as opposed to the ligation technique. One hundred and five patients had one tonsillar fossa haemostasis secured by unipolar diathermy and the opposite side by ligation technique. There was significantly less pharyngeal pain on the diathermy side in the first post-operative day. However, there was no significant difference between the two sides, both in pharyngeal discomfort and otalgia for the rest of the post-operative period. There was no difference in the incidence of haemorrhage between the two techniques.

Adolescent↗
PubMed1997

Diathermy tonsillectomy: comparisons of morbidity following bipolar and monopolar microdissection needle excision.

Tonsillectomy is frequently associated with a considerable post-operative morbidity. In some cases reactionary or secondary haemorrhage occurs and all patients suffer a degree of post-operative pain. The use of bipolar diathermy excision has become popular because it reduces intra-operative blood loss, but all diathermy inevitably produces a degree of damage to adjacent normal soft tissues. In turn this inadvertent injury must act to increase the post-operative pain. Monopolar dissection using a fine tungsten diathermy needle (the Colorado needle) allows sharp dissection at low power levels and in previous studies has been shown to produce a reduction in collateral tissue damage. In this prospective study the morbidity associated with tonsillectomy using this needle was compared to that following a standard bipolar dissection. Using the monopolar needle produced no enhanced risk of reactionary or secondary haemorrhage while causing significantly less post-operative pain and a reduction in eschar. We believe that excision using this needle preserves the advantages associated with bipolar dissection while reducing local soft tissue damage.

Adolescent↗
PubMed2002

Randomized clinical trial of Ligasure versus conventional diathermy for day-case haemorrhoidectomy.

BACKGROUND: Haemorrhoidectomy is frequently associated with postoperative pain and prolonged hospital stay. A new technique of haemorrhoidectomy using the Ligasure device suited to day-case surgery is described. This technique was compared with conventional open diathermy haemorrhoidectomy. METHODS: Forty patients with grade III or IV haemorrhoids were randomized to Ligasure (group 1) or conventional diathermy (group 2) haemorrhoidectomy. Operative details were recorded and patients recorded daily pain scores on a linear analogue scale. Follow-up was at 1, 3, 6 and 12 weeks to evaluate complications, return to normal activity, ongoing symptoms and patient satisfaction. RESULTS: Reduced intraoperative blood loss (median (range) 0 (0-5) ml versus 20 (12-22) ml; P < 0.001) and a shorter operating time (10 (8-11) versus 20 (18-25) min; P < 0.001) was observed in group 1 compared with group 2. More patients in group 1 were discharged on the day of operation (18 of 20 versus 11 of 20; P < 0.05) and there was a trend towards lower postoperative pain scores on day 1 (group 1 median 5 (95 per cent confidence interval (c.i.) 2.6 to 6.8) versus group 2 7 (95 per cent c.i. 4.2 to 7.7); P = 0.36). There was no difference between the two groups in the degree of patient satisfaction or number of postoperative complications. CONCLUSION: Ligasure diathermy may be used safely in the treatment of patients with grade III or IV haemorrhoids. It reduces intraoperative blood loss and operating time, and facilitates same-day discharge.

Adult↗
PubMed1992

Measurement of surgical diathermy current during trans-urethral resection of the prostate gland.

A system is described that has been developed to measure the surgical diathermy current passing through the patient during each cut of a trans-urethral resection of the prostate gland (TURP), with 1.5% glycine solution as irrigant. The immediate aim was to distinguish capsular tissue of the male prostate gland from the hyperplastic adenomatous tissue within it. The ultimate aim was to prevent resection into the surgical capsule which can easily result in excessive blood loss and absorption of irrigant. The system was used in a conventional theatre setting with a commercial diathermy system (Eschmann TD 411-S) of known output characteristics. Measurements were made in 12 patients during resection with a standard loop, involving typically 75 cuts in each patient (60 in adenoma and 15 in capsule). In 8 of these patients this was followed by roller ball placement on typically 10 sites each of capsule or residual adenoma at very low diathermy settings. The results showed great variability both between patients, and between different cuts in the same patient, with no consistent difference between tissues identified under direct vision as adenoma and surgical capsule. Physical reasons are suggested for the observed variability, and it is concluded that it is not possible to use this technique to guide tissue resection in the prostate.

Electrocoagulation↗
PubMed1991

Modification of the cutting thread technique for intestinal anastomoses using diathermy.

The author has modified a surgical technique, which was originally developed at the turn of the century, for the aseptic establishment of an intestinal anastomosis. The principle of this technique, known as the "cutting thread" principle, was that a loop of thread was introduced into the lumen of each of two approximated loops of intestine. After suturing the two loops of intestine together around the intraluminal parts of the thread, the latter was used as a "wire-saw" to create a stoma between the two intestinal loops. The author modified the method in such a way that the cutting could be performed with diathermy, thus avoiding the risk of uncontrollable traumatization which was inherent in the original technique. The author also used "steering" sutures which encircled the diathermy wire, preventing the wire from running "off the line". The cutting thread of the original method was replaced by a silver-plated copper wire, insulated with teflon except for a few mm in the middle and a few cm at each end. The stoma was cut with diathermy, using the uninsulated middle of the wire as an electrode. After testing in experimental animals, this technique appears to be of value in certain clinical operations, e.g. implantation of the small intestine into the caecum or colon following an ileal respective caecal resection in the horse.

Anastomosis, Surgical↗
PubMed2005

Ligasure trademark vs conventional diathermy haemorrhoidectomy: long-term follow-up of a randomised clinical trial.

OBJECTIVE: Ligasure haemorrhoidectomy has short-term benefits over conventional diathermy haemorrhoidectomy. The current study aimed to determine the long-term efficacy of Ligasure haemorrhoidectomy. SUBJECTS AND METHODS: Forty patients, previously randomised to Ligasure or diathermy haemorrhoidectomy in 2002, were invited to participate in the study. Haemorrhoidal symptoms and patient satisfaction were recorded. Incontinence was quantified and sphincter anatomy and function assessed by endoanal ultrasound and anorectal manometry. RESULTS: Thirty (75%) patients participated in the study (14 Ligasure, 16 conventional). There was no difference in age, sex distribution, or length of follow-up (Ligasure : 37 months; conventional: 36 months) between the groups. Both techniques achieved good symptom control, but with a trend to less recurrent bleeding following Ligasure. Incontinence scores and patient satisfaction were similar. A significant difference was observed in internal sphincter thickness (Ligasure : 2.5 mm, 2.2-2.8 (mean, 95%CI) vs conventional: 1.88 mm, 1.7-2.1, P = 0.005) and rectal urge sensation (Ligasure : 284 mls, 211-378 vs conventional: 173 mls, 129-217, P = 0.08). CONCLUSION: Ligasure is as effective as conventional diathermy haemorrhoidectomy in achieving long-term symptom control. Less radical haemorrhoidal excision with the Ligasure could explain the differences in internal sphincter thickness and urge sensation, and might make it the preferred method for patients with compromised sphincter function.

Digestive System Surgical Procedures↗