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At least 19 recordsLinked to original sources

A comparison of microbipolar cautery dissection to hot knife and cold knife cautery tonsillectomy.

BACKGROUND: Morbidity following tonsillectomy continues to be a major concern to parents, children, and physicians alike. Reduction in post-operative complications, optimal control of pain, and satisfactory return to a normal lifestyle are all important to both family and society. This study compares both the complication and recovery rates after microbipolar dissection (MBPD) technique of tonsillectomy to two well established tonsillectomy techniques: hot knife (HK) and cold knife/cautery (CK/C). METHODS: A total of 200 consecutive patients presenting for tonsillectomy by the first author (MP) were randomized to either undergo MBPD or HK tonsillectomy. Concurrently, an additional two hundred patients were randomized to undergo MBPD or CK/C tonsillectomy by the second author (LB). Patients were prospectively followed for complications including bleeding and dehydration and multiple indicators of recovery rate. RESULTS: Postoperative bleeding of any kind was significantly less in the MBPD group than in the CK/C and HK groups (5 vs 12.4 vs 12.5% (P<0.001). The need for post-operative intervention for bleeding, i.e. local control or return to the operating room, was also significantly less in the MBPD group. Return to normal activity occurred 2 days earlier in the MBPD group versus either CK/C or HK (P<0.001). Additionally, earlier recovery was reflected in fewer total doses of pain medication in the MBPD group. Operative time was 3-5 min longer for MBPD (24.2 min) than for CK/C or HK (21.1 and 16.5 min, respectively); blood loss was similar (within 15 cc) among all treatment groups. CONCLUSION: MBPD tonsillectomy compared most favorably to conventional techniques (CK/C and to HK tonsillectomy). Important clinical outcome differences included a lower bleed rate, earlier recovery and fewer days lost from work and school. The financial impact is estimated to be quite favorable. MBPD tonsillectomy is now our preferred method in children.

Adolescent↗

Effect of bipolar cautery on tensile strength of 6-0 polyglactin 910 suture.

PURPOSE: To determine the effect of bipolar cautery on 6-0 polyglactin 910 suture. METHODS: Three groups of sutures were tested for maximum tensile strength. The first group (direct cautery) had bipolar cautery applied directly to the suture. The second group (scleral cautery) had bipolar cautery applied directly on top of the sclera, through which the suture was passed one-half scleral thickness. The third group (control) had no application of cautery to the suture. RESULTS: The mean tensile strength for the direct cautery sutures (n=8) was 553 g; for the scleral cautery sutures (n=7), 577 g; and for the control sutures (n=5), 553 g. There was no statistically significant difference in tensile strength between the three groups, with the analysis of variance yielding P=.56. CONCLUSION: Bipolar cautery causes little to no risk of reducing the tensile strength of 6-0 polyglactin 910 suture in the setting of strabismus surgery.

Cautery↗

Neuroprotection due to irrigation during bipolar cautery.

OBJECTIVE: To test whether irrigation during bipolar cautery confers thermoprotection from neuronal injury. DESIGN: A rat animal model (15 rats for each treatment group) was used to test the thermoprotective effects of irrigation during bipolar cautery. In this model, the sciatic nerve was exposed, and a 1-second stimulus was applied using bipolar cautery forceps at 40 or 20 W placed directly on the nerve in the presence or absence of simultaneous irrigation. The effects of cautery were determined on the basis of clinical gait analysis by means of the Sciatic Functional Index, temperature response, and neuropathological findings. RESULTS: The degree of paresis was reduced with irrigation. Neuropathological examination of the sciatic nerve after cautery showed significant axonal loss (more small than large fibers) with concomitant demyelination, which was partially inhibited by irrigation (chi2; P = .04). The mechanism of thermoprotection by irrigation was not the result of a reduction in the temperature spike that followed cautery, but resulted from a reduced temperature response during the 15 seconds that followed 40- or 20-W stimulation with bipolar cautery. CONCLUSIONS: Simultaneous irrigation and bipolar cautery enhance temperature recovery to basal levels and protect the peripheral nerve from the effects of cautery.

Animals↗

Color pattern formation on the wing of the butterfly Pieris rapae. 1. Cautery induced alteration of scale color and delay of arrangement formation.

Experimental approaches to color pattern formation of lepidopteran insects have been made exclusively by analyzing pattern alterations in adult wings induced by operations. We microcauterized the presumptive black region of the dorsal forewing of the butterfly Pieris rapae and analyzed not only the resultant color pattern in the adult wing but also the cell behavior in the pupal wing epidermis around the injury. Cautery induced color alterations were as follows: (i) cautery up to 49.5 h after pupation resulted in white regions appearing within the black region while later cauteries induced larger white regions; (ii) cautery between 50 and 59.5 h resulted in the white regions induced by the cauteries being dramatically decreased; (iii) cautery after 60 h resulted in white regions that had almost disappeared. The examination of the cell behavior in the pupal wing epidermis after cauteries showed that the row formation of scale precursor cells was delayed. This delayed area varied with the time of cautery, in the same manner as that in the induced white area in the adult wing ((i)-(iii) above). The relationship between scale color alteration and the developmental delay of the scale row formation is discussed.

Animals↗

Thermoprotective mechanisms of irrigation during bipolar cautery.

Bipolar cautery is routinely used in operations of the head and neck, as well as in other specialties, both for dissection and for achieving hemostasis. Whereas simultaneous irrigation is frequently used to minimize neuronal injury, its effectiveness has not been tested under controlled conditions. Our objectives in this study were to test the hypothesis that including irrigation during bipolar cautery is thermoprotective and to identify the mechanisms underlying the thermoprotective effect. The thermoprotective role of irrigation with bipolar cautery was tested in a rat model in which the sciatic nerve was exposed and a 1-second stimulus at 40 or 20 watts was applied with bipolar cautery forceps placed directly on the nerve in the presence or absence of simultaneous irrigation. We used the Sciatic Functional Index as used to quantitate the degree of paresis induced. The results showed that simultaneous irrigation reduced the percentage of animals showing paresis. This effect was significant for animals exposed to 40- and 20-watt cautery. The mechanism for the reduction in the degree of paresis by irrigation could not be attributed to a lowering of the maximal temperature achieved after bipolar cautery. Instead, the thermoprotective mechanism of the irrigation involved an enhanced recovery to basal temperatures when measured at 15 seconds after nerve stimulation with 40 or 20 watts. Reducing the power from 40 watts to 20 watts did not significantly lessen the tissue temperature. The results of this study suggest that irrigation done simultaneously with bipolar cautery enhances temperature recovery to basal levels and plays a role in thermoprotection against the effects of cautery.

Animals↗

Thermal cautery after chalazion surgery and its effect on recurrence rates.

BACKGROUND: Chalazion surgery is a common minor surgical procedure used to treat internal chalazia after conservative measures have failed. Complications are infrequent and generally easily managed with minimal problems. In this clinical research study, 100 internal chalazia surgical candidates were randomly divided into two treatment groups. Our initial goal was to ascertain whether cautery impacted the recurrence rates on chalazia in these patients. One group received thermal cautery after surgical incision and drainage. The second group did not receive cautery after incision and drainage. Lack of cautery caused no problems with hemostasis because bleeding resolved without incident after several additional minutes. METHODS: The study was conducted on 100 patients who received 4 weeks of conservative treatment consisting of alternating warm and cold compresses and topical prednisolone acetate/sulfa medication (e.g., blephamide) administered 4 times a day. A transconjunctival incision and drainage was performed, followed by thermal cautery in one-half (N = 50) of the randomized patients. RESULTS: The cauterized group had a 78% no recurrence rate after 6 months and good surgical outcomes. The remaining 22% had a recurrence of chalazia, but with good initial surgical outcome. The noncauterized group (N = 50) showed a 74% no recurrence rate after 6 months and good surgical outcome. The remaining 26% had recurrences with good initial surgical outcomes. A chi-square test indicated that there was no significant statistical difference between the groups (chi2 = 0.219, dF = 1.0, p = 0.640). CONCLUSION: The results of this clinical study suggest that the use of thermal cautery with surgery has no impact on the recurrence rate of internal chalazia. Thus, the use of thermal cautery should be left to the discretion of the eye care practitioner.

Adolescent↗

A comparison of vas occlusion techniques: cautery more effective than ligation and excision with fascial interposition.

BACKGROUND: Vasectomy techniques have been the subject of relatively few rigorous studies. The objective of this analysis was to compare the effectiveness of two techniques for vas occlusion: intraluminal cautery versus ligation and excision with fascial interposition. More specifically, we aimed to compare early failure rates, sperm concentrations, and time to success between the two techniques. METHODS: We compared semen analysis data from men following vasectomy using two occlusion techniques. Data on intraluminal cautery came from a prospective observational study conducted at four sites. Data on ligation and excision with fascial interposition came from a multicenter randomized controlled trial that evaluated the efficacy of ligation and excision with versus without fascial interposition. The surgical techniques used in the fascial interposition study were standardized. The surgeons in the cautery study used their customary techniques, which varied among sites in terms of type of cautery, use of fascial interposition, excision of a short segment of the vas, and use of an open-ended technique. Men in both studies had semen analyses two weeks after vasectomy and then approximately every four weeks. The two outcome measures for the analyses presented here are (a) time to success, defined as severe oligozoospermia, or <100,000 sperm/mL in two consecutive semen analyses; and (b) early vasectomy failure, defined as >10 million sperm/mL at week 12 or later. RESULTS: Vasectomy with cautery was associated with a significantly more rapid progression to severe oligozoospermia and with significantly fewer early failures (1% versus 5%). CONCLUSION: The use of cautery improves vasectomy outcomes. Limitations of this comparison include (a) the variety of surgical techniques in the cautery study and differences in methods of fascial interposition between the two studies, (b) the uncertain correlation between sperm concentrations after vasectomy and the risk of pregnancy, and (c) the use of historical controls and different study sites.

Cautery↗

Comparison of electro and chemical cautery in the treatment of anterior epistaxis.

In the ENT Department of the Royal Victoria Hospital, Belfast, the impression (supported only by anecdotes) was that electro-cautery was superior to chemical cautery in the treatment of simple anterior epistaxis. Since no evaluation of the relative merits of electro and chemical cautery has been reported, a prospective randomized study was conducted to assess the effectiveness of electro-cautery and cautery with silver nitrate. The results of the study showed that there was no statistically significant difference between the two methods in either controlling the epistaxis or in the incidence of complications. It is concluded that since cautery with a silver nitrate tipped applicator is simpler, and of equal effectiveness, it would appear to be the treatment of choice for simple anterior epistaxis.

Adult↗

[Expression and significance of vascular endothelial growth factor in rat cornea after cautery with alkali].

OBJECTIVE: To investigate the expression of vascular endothelial growth factor (VEGF) in rat cornea after cautery with alkali. METHODS: In Sprague-Dawley rats, inflammatory corneal neovascularization was induced by cautery with alkali. VEGF was detected in corneal samples at different times by Western-blot, and immunohistochemistry method was used to investigate the distribution of VEGF at rat cornea after cautery with alkali. RESULTS: The normal rat corneas did not express VEGF. The expression of VEGF increased with time after corneal cautery. The rat corneas were infiltrated by massive inflammatory cells that, especially adjacent to the cautery lesion, showed staining for VEGF. CONCLUSION: VEGF production by inflammatory cells participates in inflammatory angiogenesis in rat corneas. VEGF has the effects on the induction and supporting of cautery-induced angiogenesis in rat cornea.

Alkalies↗

Cautery-induced colour patterns in Precis coenia (Lepidoptera: Nymphalidae).

Cautery of the dorsal hindwing in the butterfly, Precis coenia, induces the formation of a concentric colour pattern around the site of injury. The induced pattern is identical in pigmentation to the eyespots that normally develop on this wing surface. This response to cautery also occurs, though much less dramatically, on the ventral forewing. In addition to the peculiar response to cautery, the dorsal hindwing of Precis also develops a series of unique pattern aberrations in response to coldshock. These consist of irregular elongation of the anterior eyespot along the proximodistal axis of the wing. In the most dramatic aberrations the eyespot field covers the entire anterior half of the wing surface. An analysis is presented that attempts to reconcile the effects of cautery on the Precis hindwing with the very different morphological effects of cautery on the colour pattern of Ephestia kühniella, described by Kühn & Von Engelhardt. Computer simulations reveal that the finding presented in this paper, as well as the classical work on Ephestia, can both be explained by assuming that the site of cautery becomes a sink for one of the morphogens involved in colour pattern determination. The experimental findings furthermore indicate that minor perturbations of the wing epidermis can evoke the physiological conditions that attend normal eyespot determination. It is shown that this interpretation also helps to explain the unusual pattern modifications following coldshock.

Animals↗

A new fine probe for electric cautery during endoscopic surgery.

The present paper introduces a new fine probe for electric cautery (1.65 mm in diameter, 22 cm long) that can be connected to a conventional cylindrical hand-controlled cautery holder, which is monopolar and widely used in general surgery. When cautery was required, a 14-gauge intravenous catheter was inserted at an appropriate site under the guidance of a videoscope. After removing the steel inner needle, the extra tube was used as the fine surgical port for the cautery probe. The position of insertion could be altered according to the operating field. Cautery was performed by conventional methods. There was no bleeding or air leakage at the site of puncture during or after surgery. The puncture wound was closed without any sutures. Based on these results, the new fine probe for cautery can reduce the number of surgical ports required for instruments during video-assisted surgery, thus improving the ease and safety of endoscopic surgery.

Electrocoagulation↗

Topical anaesthesia for bladder biopsies and cautery: intravesical lidocaine versus caudal anaesthesia.

A total of 62 patients were randomized to receive bladder biopsy and cautery with either topical lidocaine anaesthesia or caudal anaesthesia. The patients were asked to describe the level of pain experienced during the procedure on a scale from 0 (no pain) to 5 (unbearable pain). In 29 patients receiving topical lidocaine anaesthesia, the mean value was 1.6 at cold-cup biopsies and 2.7 at cautery, which were considered to be tolerable for the patients. On the other hand, in 33 patients who had biopsies and cautery with caudal anaesthesia, the mean values were 0.8 and 1.0, respectively, which were significantly lower than those in patients receiving topical anaesthesia (p < 0.01). Serum lidocaine levels were measured in 5 patients at 15 minutes from the beginning of biopsies, and were negligible. These results revealed that caudal anaesthesia provided more effective pain relief, although most patients could tolerate biopsy and cautery with topical lidocaine anaesthesia. The technique of topical anaesthesia is very simple and no side effects were observed. We thus conclude that topical lidocaine anaesthesia is useful and safe for bladder biopsies and cautery in most cases.

Administration, Intravesical↗

Acute cortisol responses of calves to scoop dehorning using local anaesthesia and/or cautery of the wound.

OBJECTIVE: To measure plasma cortisol responses in calves dehorned using a scoop after administration of local anaesthesia and/or cautery of the wounds. DESIGN: A physiological study with controls. PROCEDURE: There were six treatments: control handling with and without local anaesthesia, dehorning, dehorning after local anaesthesia, dehorning followed by wound cautery, and dehorning after local anaesthesia followed by wound cautery. Blood samples were taken before and after dehorning. RESULTS: Dehorning caused an increase in plasma cortisol concentrations, which decreased a little to plateau values and then declined to pretreatment values 3 to 4 h after dehorning. The peak was smaller after local anaesthesia was administered but when its effects wore off, cortisol concentrations increased and thereafter were similar to those in the dehorned animals. The combination of local anaesthesia and cautery resulted in a plasma cortisol response similar to those in control calves with or without local anaesthesia. CONCLUSIONS: If plasma cortisol concentrations reflect the distress being experienced by the calves, then local anaesthesia reduces the acute distress for about 3 h after dehorning but not during the subsequent 3 to 4 h. Combining local anaesthetic and cautery prevented the significant increase in plasma cortisol following dehorning and may eliminate the acute distress caused by scoop dehorning.

Anesthesia, Local↗

Thermal cautery of the cornea for treatment of spontaneous chronic corneal epithelial defects in dogs and horses.

A thermal cautery technique was used to treat spontaneous chronic corneal epithelial defects (SCCEDs) in 9 eyes of 8 dogs and 2 eyes of 2 horses. Animals were sedated, and a topical anesthetic was applied. A handheld thermal cautery unit was then used to make multiple, small (< or = 1 mm in diameter), superficial burns throughout the affected area. The cautery unit was applied just until the slightest degree of contraction of the collagen fibrils was observed. After the stromal bed of the defect was treated, a rim of epithelium that extended approximately 1 mm around the denuded stroma was also subjected to thermal cautery. Following surgery, a contact lens was placed in dogs but not in horses, and the eye was treated with broad-spectrum antimicrobial ophthalmic solutions. Defects in all 11 eyes healed with minimal scarring; mean time to healing in dogs was 2.1 weeks (range, 2 to 3 weeks). The defect healed in 1 week in 1 horse and in 2 weeks in the other. Many therapeutic options are available for the treatment of SCCEDs. Procedures such as epithelial debridement and anterior stromal puncture have been shown to have a high rate of success. In cases for which these less invasive procedures fail, our results suggest that thermal cautery may be a reasonable alternative to previously described treatments for SCCEDs in dogs and horses prior to more invasive procedures such as superficial keratectomy.

Animals↗

Adhesion formation after laparoscopic ovarian cautery for polycystic ovarian syndrome: lack of correlation with pregnancy rate.

OBJECTIVE: To assess adhesion formation after laparoscopic ovarian cautery in women with polycystic ovarian syndrome (PCOS) and the efficacy of Interceed Adhesion Barrier (Ethicon, Summerville, NJ) in their prevention. DESIGN: Prospective, randomized, blinded, clinical study of laparoscopic ovarian cautery with application of Interceed to one ovary, followed by short interval second-look laparoscopy, scoring of adhesions, and clinical follow-up. SETTING: Tertiary care clinic at a University teaching hospital. PATIENTS: Eight infertile women with PCOS who failed to conceive with previous clomiphene citrate (CC) therapy. RESULTS: Periovarian adhesions of varying severity developed in all women after laparoscopic ovarian cautery. Interceed showed no protective effect. Despite this finding, all women initiated regular menses after laparoscopic ovarian cautery and seven of eight women spontaneously conceived eight singleton pregnancies without any further therapy. CONCLUSION: Laparoscopic ovarian cautery should be considered in infertile women with PCOS who fail to respond to CC therapy. These women must be counseled with respect to the possible complication of postoperative adhesion formation.

Adult↗

Tubal anastomosis: pregnancy success following reversal of Falope ring or monopolar cautery sterilization.

The present study reviews pregnancy outcome following tubal anastomosis in 80 previously sterilized women. Thirty of 58 women (52%) sterilized by monopolar cautery techniques delivered a living child as compared to 19 of 22 women (86%) sterilized using the Falope ring method. Cumulative pregnancy curves were calculated for the Falope ring and cautery groups using life-table methods. Following reversal of Falope ring sterilization, the estimated cumulative probability of pregnancy 6, 12, 24, and 36 months after surgery was 28.4%, 48.8%, 69.3%, and 87.2% respectively. The corresponding estimates following reversal of cautery sterilization were lower at 6, 12, 24, and 36 months following surgery: 22.7%, 37.8%, 52.4%, and 57.9%, respectively. The ectopic tubal pregnancy and spontaneous abortion rate were higher among women sterilized with monopolar cautery. A decreased pregnancy rate was associated with ampullary-isthmic anastomosis in the cautery group; however, pregnancy was least likely to occur in women with shortened oviducts of less than 4 cm.

Actuarial Analysis↗

[An ophthalmological cautery (author's transl)].

A microcautery specially developed for ophthalmological procedures--in contrast to the cauteries commonly used in ophthalmology--is described. It is a foot-operated unit controlled by the surgeon or his assistant. The power settings for the cautery tip are designed to permit easy selection of optimum current flow. The pre-selected cautery temperature is not affected by switching on and off or by the cautery tip becoming red-hot. There is a continuous audible signal as long as power is reaching the cautery tip. The device has been in use for three years without giving trouble.

Electrocoagulation↗