Injury and adhesion formation following ovarian wedge resection with different thermal surgical modalities

N. Bhatta, K. Isaacson, Thomas J Flotte, I. Schiff, R. R. Anderson

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

The purpose of this study is to determine the role of bleeding, acute thermal damage, and charring in adhesion formation. Post-operative adhesions were compared following ovarian wedge resection in 48 rabbits using different lasers, electrosurgery, and scalpel. Twelve ovaries were sectioned per modality, in randomized pairs. Acute thermal injury as assessed by histology, bleeding, and charring differed among the modalities used. Adhesions were assessed 4 weeks later, by an investigator completely blinded of the treatment protocol. The adhesion scores were 11.6 ± 8.0 with pulsed Er:YAG laser; 11.9 ± 7.5 with scalpel; 8.3 ± 9.3 with electrocautery; 6.7 ± 8.8 with a continuous (c.w.) Nd:YAG laser; 5.3 ± 4.8 with c.w. CO 2 laser; 3.1 ± 2.7 with pulsed CO 2 laser; 1.7 ± 1.8 with pulsed Ho:YAG laser; and 0.8 ± 1.5 in the control (no resection) group. Ho:YAG, Nd:YAG, and electrocautery were completely hemostatic. Bleeding was minimal with the CO 2 lasers. Er:YAG and scalpel caused maximum bleeding, requiring hemostatic measures to prevent exanguination. Charring occurred with electrocautery, CO 2 laser, and Nd:YAG laser. Bleeding and charring correlated with adhesion formation, but the histological depth of thermal damage did not. The Ho:YAG laser is a hemostatic, fiber-optic compatible laser causing significantly fewer adhesions (P<0.04) than scalpel, electrocautery, Nd:YAG, Er:YAG, and c.w. CO 2 lasers. Clinical use of the Ho:YAG laser, and the role of carbonization in promoting adhesions, deserve further study.

Original languageEnglish (US)
Pages (from-to)344-352
Number of pages9
JournalLasers in Surgery and Medicine
Volume13
Issue number3
StatePublished - 1993
Externally publishedYes

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Solid-State Lasers
Carbon Monoxide
Electrocoagulation
Lasers
Hot Temperature
Hemorrhage
Wounds and Injuries
Hemostatics
Electrosurgery
Laser Therapy
Clinical Protocols
Ovary
Histology
Research Personnel
Rabbits

ASJC Scopus subject areas

  • Surgery

Cite this

Injury and adhesion formation following ovarian wedge resection with different thermal surgical modalities. / Bhatta, N.; Isaacson, K.; Flotte, Thomas J; Schiff, I.; Anderson, R. R.

In: Lasers in Surgery and Medicine, Vol. 13, No. 3, 1993, p. 344-352.

Research output: Contribution to journalArticle

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