We here in the paper, not only introduce the development of electricsurgical operation equipment in our country and foreign countries but also represent the characters, principles and usages of several kinds electrosurgical equipment in foreign countries.
Argon ; Catheter Ablation ; instrumentation ; Electrocoagulation ; instrumentation ; Electrosurgery ; instrumentation ; Humans ; Ions

A novel system is proposed to control the liquid nitrogen cooling and radio frequency heating of tissue to achieve effective thermal ablation in the treatment using fuzzy logic controller and fuzzy logic PID type controller separately. Results of ex-vivo pig liver experiments demonstrate that this system is useful and could p control the desired treatment procedure.
Algorithms ; Animals ; Computer Simulation ; Cryotherapy ; instrumentation ; methods ; Electrocoagulation ; instrumentation ; methods ; Equipment Design ; Fuzzy Logic ; Liver ; Swine

BACKGROUND: The efficacy of saline-coupled bipolar sealing devices in joint arthroplasty is uncertain, and the utility in simultaneous bilateral total knee arthroplasty (TKA) has not been reported. METHODS: This study compares the use of bipolar sealing and conventional electrocautery in 71 consecutive patients. The experimental and control groups were matched for age, sex, body mass index, American Society of Anesthesiologists (ASA) classification, and preoperative hemoglobin. Variables of interest included blood loss, transfusion requirements, and operative characteristics. RESULTS: In comparison to patients treated with conventional electrocautery, those treated with the bipolar sealer were 35% less likely to require transfusion. The median number of transfusions per case was also significantly lower in the experimental group. Hemoglobin change, total blood loss, and length of stay were not significantly different between the groups. The experimental group had longer operative times. CONCLUSIONS: Bipolar sealing shows promise as a blood loss reduction tool in simultaneous bilateral TKA. The marginal savings attributed to reduced transfusion rates with use of the bipolar sealer did not exceed the additional per-case expense of using the device. The decision to use the device with the goal of less blood loss must come with the additional expense associated with its use.
Adult ; *Arthroplasty, Replacement, Knee ; Blood Loss, Surgical/*prevention & control ; Catheter Ablation/instrumentation ; Electrocoagulation/*instrumentation ; Female ; Humans ; Male

OBJECTIVE: To determine whether saline-enhanced dual probe bipolar radiofrequency ablation (RFA) using perfused-cooled electrodes shows better in-vitro efficiency than monopolar or single probe bipolar RFA in creating larger coagulation necrosis. MATERIALS AND METHODS: RF was applied to excised bovine livers in both bipolar and monopolar modes using a 200W generator (CC-3; Radionics) and the perfused-cooled electrodes for 10 mins. After placing single or double perfused-cooled electrodes in the explanted liver, 30 ablation zones were created at three different regimens: group A; saline-enhanced monopolar RFA, group B; saline-enhanced single probe bipolar RFA, and group C; saline-enhanced dual probe bipolar RFA. During RFA, we measured the tissue temperature at 15 mm from the electrode. The dimensions of the ablation zones and changes in the impedance currents and liver temperature during RFA were then compared between the groups. RESULTS: The mean current values were higher for monopolar mode (group A) than for the bipolar modes (groups B and C) : 1550+/-25 mA in group A, 764+/-189 mA in group B and 819+/-98 mA in group C (p < 0.05). The volume of RF-induced coagulation necrosis was greater in group C than in the other groups: 27.6+/-2.9 cm3 in group A, 23.7+/-3.8 cm3 in group B, and 34.2+/-5.1 cm3 in group C (p < 0.05). However, there was no significant difference between the short-axis diameter of the coagulation necrosis in the three groups: 3.1+/-0.8 cm, 2.9+/-1.2 cm and 4.0+/-1.3 cm in groups A, B and C, respectively (p > 0.05). The temperature at 15 mm from the electrode was higher in group C than in the other groups: 70+/-18 degrees C in group A, 59+/-23 degrees C in group B and 96+/-16 degrees C in group C (p < 0.05). CONCLUSION: Saline-enhanced bipolar RFA using dual perfused-cooled electrodes increases the dimension of the ablation zone more efficiently than monopolar RFA or single probe bipolar RFA.
Animals ; Catheter Ablation/*instrumentation ; Cattle ; Comparative Study ; Electrocoagulation ; In Vitro ; Liver/pathology/*surgery ; Necrosis ; Sodium Chloride ; Support, Non-U.S. Gov't

OBJECTIVE: To determine in vivo efficacy of radiofrequency ablation (RFA) in porcine liver by using 15-gauge Octopus(R) (15-G Octopus(R)) electrodes to create a large coagulation. MATERIALS AND METHODS: A total of 18 coagulations were created by using a 180-W generator and 15-G Octopus(R) electrodes during laparotomy, performed in 14 pigs. Coagulation necrosis was created in the pig livers by the use of one of three RFA protocols: 1) group A, monopolar RFA using a 15-G Octopus(R) electrode with a 5-mm inter-electrode distance (n = 4); 2) group B, monopolar RFA using a 15-G Octopus(R) electrode with a 10-mm inter-electrode distance (n = 6); and 3) group C, switching monopolar RFA using two 15-G Octopus(R) electrodes (n = 8). The energy efficiency, shape, maximum and minimum diameters (Dmx and Dmi), and the volume of the coagulation volume were measured in each group. The Summary statistics were obtained and Mann-Whitney test was were performed. RESULTS: The mean ablated volume of each group was 49.23 cm3 in A, 64.11 cm3 in B, and 72.35 cm3 in C. The mean Dmx and Dmi values were 5.68 cm and 4.58 cm in A and 5.97 cm and 4.97 cm in B, respectively. In group C, the mean diameters of Dmx and Dmi were 6.80 cm and 5.11 cm, respectively. The mean ratios of Dmi/Dmx were 1.25, 1.20, and 1.35 in groups A, B, and C, respectively. There was one animal death during the RFA procedure, the cause of which could not be subsequently determined. However, there were no other significant, procedure-related complications during the seven-hour-delayed CT scans. CONCLUSION: RFA procedures using 15-G Octopus(R) electrodes are useful and safe for creating a large ablation in a single electrode model as well as in the multiple electrodes model.
Animals ; Catheter Ablation/*methods ; Electrocoagulation/*instrumentation ; *Electrodes ; Liver/radiography/*surgery ; Statistics, Nonparametric ; Swine ; Tomography, X-Ray Computed

Anastomotic stenosis of the colon is not an uncommon finding; however, its frequency varies from one study to another. Traditionally, postoperative colonic stenosis is managed surgically. However, endoscopic therapy has recently become the preferred treatment modality over traditional surgery. Good short-term success has been achieved with use of endoscopic balloon dilation; however, restenosis may occur over time in 14% to 25% of patients. The current report showed the effectiveness and usefulness of an insulated-tip knife (IT-knife) for electrocautery therapy of a patient with symptomatic anastomotic colonic stenosis.
Aged ; Colonoscopy ; Constriction, Pathologic/*therapy ; Electrocoagulation/instrumentation/*methods ; Humans ; Male ; Middle Aged ; Rectal Neoplasms/radiography/*surgery ; Sigmoid Neoplasms/radiography/*surgery ; Tomography, X-Ray Computed

OBJECTIVE: A number of new techniques have been developed to prevent lymphocele formation after pelvic lymphadenectomy in gynecologic cancers. We assessed whether the electrothermal bipolar vessel sealing device (EBVSD) could decrease the incidence of postoperative lymphocele secondary to pelvic lymphadenectomy. METHODS: A total of 321 patients with gynecologic cancer underwent pelvic lymphadenectomy from 2005 to 2011. Pelvic lymphadenectomy without EBVSD was performed in 134 patients, and pelvic lymphadenectomy with EBVSD was performed in 187 patients. We retrospectively compared the incidence of lymphocele and symptoms between both groups. RESULTS: Four to 8 weeks after operation, 108 cases of lymphocele (34%) were detected by computed tomography scan examination. The incidence of lymphocele after pelvic lymphadenectomy was 56% (75/134) in the tie ligation group, and 18% (33/187) in the EBVSD group. We found a statistically significant difference in the incidence of lymphocele between both groups (p<0.01). To detect the independent risk factor for lymphocele development, we performed multivariate analysis with logistic regression for three variables (device, number of dissected lymph nodes, and operation time). Among these variables, we found a significant difference (p<0.001) for only one device. CONCLUSION: Use of the EBVSD during gynecological cancer operation is useful for preventing the development of lymphocele secondary to pelvic lymphadenectomy.
Adult ; Electrocoagulation/instrumentation/*methods ; Female ; Genital Neoplasms, Female/pathology/*surgery ; Humans ; Lymph Node Excision/adverse effects/*methods ; Lymphatic Metastasis ; Lymphocele/etiology/*prevention & control ; Middle Aged ; Neoplasm Staging ; Pelvis ; Retrospective Studies ; Risk Factors

BACKGROUND AND OBJECTIVECT-guided microwave coagulation is a minimally invasive surgery for patients with liver cancer. Total intravenous anesthesia with propofol and fentanyl is commonly used. The depth of anesthesia during microwave coagulation for liver cancer is still monitored by clinical signs. There are few subjective and effective indicators. This study explored the application of Narcotrend-assisted "depth of anesthesia" monitoring on microwave coagulation for patients with liver cancer during total intravenous anesthesia with propofol and fentanyl.

METHODSForty liver cancer patients underwent CT-guided microwave coagulation were randomly assigned to receive Narcotrend index monitoring or standard clinical monitoring for depth of anesthesia with 20 patients in each group. All patients received total intravenous anesthesia with propofol and fentanyl. The depth of anesthesia for patients in the Narcotrend group was measured according to a Narcotrend index, which was maintained between D2 and E0. The depth of anesthesia for those in the standard clinical practice group was measured according to heart rate, mean arterial pressure, and patient movement. Changes of hemodynamics, the duration of the emergence from anesthesia, and the recovery of orientation were recorded. The doses of propofol and fentanyl, postoperative visual analogue scores (VAS), and the incidence of postoperative nausea and vomiting were also recorded.

RESULTSThere was no significant alteration in heart rate or mean arterial pressure between the two groups. Compared with other anesthetic stages, both heart rate and mean arterial pressure decreased during the induction of the anesthesia in the two groups(P<0.05). The doses of propofol were higher in the standard clinical practice group than in the Narcotrend group [(460+/-30) mg vs. (380+/-35) mg, P<0.01]. The duration of emergence and orientation were longer in the standard clinical practice group than in the Narcotrend group [(9.5+/-2.9) min vs. (4.9+/-2.2) min, P<0.01; (12.2+/-3.5) min vs. (6.6+/-3.2) min, P<0.01, respectively]. There was no difference in the dosage of fentanyl, VAS, or the incidence of postoperative nausea or vomiting between the two groups (P>0.05).

CONCLUSIONFor patients with liver cancer, monitoring the depth of anesthesia with Narcotrend on microwave coagulation can contribute to lower dosage of propofol and shorten duration of recovery during total intravenous anesthesia with propofol and fentanyl.

Adult ; Aged ; Anesthesia, Intravenous ; Anesthetics, Intravenous ; administration & dosage ; Electrocoagulation ; methods ; Fentanyl ; administration & dosage ; Hemodynamics ; Humans ; Liver Neoplasms ; surgery ; Male ; Microwaves ; Middle Aged ; Monitoring, Intraoperative ; instrumentation ; methods ; Propofol ; administration & dosage ; Tomography, X-Ray Computed

BACKGROUNDPercutaneous radiofrequency thermocoagulation of the trigeminal ganglion (PRTTG) is regarded as the first choice for most patients with trigeminal neuralgia (TN) because of its safety and feasibility. However, neuronavigator-guided PRTTG has been seldom reported. The purpose of this study was to assess the safety and efficacy of neuronavigator-guided PRTTG for the treatment of intractable TN.

METHODSBetween January 2000 and December 2004, 54 patients with intractable TN were enrolled into this study and were randomly divided into two groups. The patients in navigation group (n = 26) underwent PRTTG with frameless neuronavigation, and those in control group (n = 28) received PRTTG without neuronavigation. Three months after the operation, the efficacy, side effects, and complications of the surgery were recorded. The patients in the control group were followed up for 10 to 54 months (mean, 34 +/- 5), and those in the navigation group were followed up for 13 to 58 months (mean, 36 +/- 7). Kaplan-Meier analyses of the pain-free survival curves were used for the censored survival data, and the log-rank test was used to compare survival curves of the two groups.

RESULTSThe immediate complete pain-relief rate of the navigation group was 100%, whereas it was 95% in the control. The proportion of sustained pain-relief rates at 12, 24 and 36 months after the procedure were 85%, 77%, and 62% in the navigation group, and 54%, 40%, and 35% in the control. Recurrences in the control group were more common than that in the navigation group. Annual recurrence rate in the first and second years were 15% and 23% in the navigation group, and 46%, 60% in the control group. No side-effect and complication was noted in the navigation group except minimal facial hypesthesia.

CONCLUSIONNeuronavigator-guided PRTTG is a safe and promising method for treatment of intractable TN with better short- and long-term outcomes and lower complication rate than PRTTG without neuronavigation.

Aged ; Electrocoagulation ; adverse effects ; instrumentation ; methods ; Female ; Follow-Up Studies ; Humans ; Hypesthesia ; etiology ; Male ; Middle Aged ; Recurrence ; Survival Analysis ; Survival Rate ; Treatment Outcome ; Trigeminal Ganglion ; pathology ; surgery ; Trigeminal Neuralgia ; mortality ; surgery