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[Variations in intraperitoneal temperature during laparoscopic cholecystectomy]
1Université Paris XIII, UFR de médecine de Bobigny-Bondy, service de chirurgie générale et digestive, CHU Jean-Verdier, France.
Study Aim:
The aim of this study was to measure thermal variation during laparoscopy in the vicinity of heat sources such as monopolar (MC), bipolar (BC) and ultrasound coagulation (USC) and to evaluate their possible negative consequences for the patient.
Methods:
This study included 67 patients who underwent laparoscopic cholecystectomy. The temperature measurements were taken with a sterile thermal probe introduced through a 5 mm trocar, coupled with a recording monitor reading variations between 20 degrees and 80 degrees C. The variation in temperature was measured as a function of the power applied to the electrodes (20 or 30 W) and in relation to the distance (1, 2, 3, 4, and 5 cm) from the electrodes.
Results:
The temperature varied by 3 degrees for BC, 29 degrees for MC and only 0.2 degree for USC when the distance increased for 1 to 5 cm. Depending on the power delivered, (20 or 30 W or 1 to 5 for USC), the variations were 1 degree for BC, 17 degrees for MC and there was still no variation for USC.
Conclusion:
The use of bipolar coagulation and ultrasonic coagulation associated with minimal temperature variations is the option of choice for operating near structures such as the common bile duct or the gastrointestinal tract.