0
Correspondence |

Energized Dissection, Energized Hemostasis—Reply

David J. Humes, PhD, MRCS; Dileep N. Lobo, DM, FRCS
Arch Surg. 2010;145(10):1021. doi:10.1001/archsurg.2010.199.
Text Size: A A A
Published online

Extract

In reply

We thank Dr Agarwal for his comments on our recent article1 and are pleased that he shares our concern for the indiscriminate use of monopolar diathermy and other electrosurgical instruments during both open and minimally invasive surgery. He rightly points out that the temperature at the tip of electrosurgical instruments remains elevated for a while after their use. Recent work from our group2 has shown that after use of a monopolar diathermy instrument for 15 seconds, its tip's temperature can be elevated above 42°C (the temperature at which coagulative necrosis occurs) for 55 seconds. Shorter durations of elevated temperatures were seen with bipolar diathermy, the Ligasure (Valleylab, Boulder, Colorado), and the Harmonic Scalpel (Ethicon Endo-Surgery, Cincinnati, Ohio). More importantly, application of monopolar diathermy to ex vivo tissue at 40 W for 10 seconds resulted in a temperature rise up to 60°C in contiguous tissue 1 cm away from the point of application. We support Dr Agarwal's call for the judicious use of electrosurgical instruments and feel that surgeons should be aware of these potential dangers.

Sign In to Access Full Content

Don't have Access?

Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more

Subscribe for full-text access to content from 1998 forward and a host of useful features

Activate your current subscription (AMA members and current subscribers)

Purchase Online Access to this article for 24 hours

First Page Preview

View Large
/>
First page PDF preview

Figures

Tables

References

Correspondence

October 1, 2010
Brij B. Agarwal, MBBS, MS, Dip Yoga, FIMSA
Author Affiliation: Dr Agarwal's Surgery & Yoga, Delhi, India.
Arch Surg. 2010;145(10):1021. doi:10.1001/archsurg.2010.198.
CME
Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).
Submit a Comment

Multimedia

Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

Related Content

Customize your page view by dragging & repositioning the boxes below.

Articles Related By Topic
Related Topics
PubMed Articles
Jobs
brightcove.createExperiences();