Bipolar electrosurgical sphincterotomy

We tested a newly developed bipolar sphincterotome. Monopolar and bipolar sphincterotomes were employed to cut small bowel smoothly and hemostatically. The bipolar instrument required 17.1 watts while the monopolar required 29.2 watts; these values are significantly different at p = 0.005. Bipolar sphincterotomies were performed via open surgical access on eight dogs. The animals were allowed to recover and were followed for 6 weeks. There was no evidence of stenosis or common duct dilation at autopsy, and serum alkaline phosphatase and bilirubin were within normal limits. Both sphincterotomes were used to cut tissue in vitro and histological examination displayed no evidence of thermal injury at the return electrode site of the bipolar sphincterotome. The lower power levels required by the bipolar sphincterotome may decrease procedure complications.