Anastomosis of biliary tissue with high-frequency electrical diathermy

Laser tissue fusion results from the conversion of light to thermal energy, creating tissue heating and protein denaturation. Accurately controlled tissue heating from smaller, less expensive, non-laser sources should be able to duplicate the fusion or welding of tissues, which has been demonstrated with a variety of lasers. We examined the capability of high-frequency electrical diathermy to create effective tissue fusion with limited collateral thermal damage. Using an electrical diathermy device with up to 14 W output power at 13.56 MHz, the cystic ducts of freshly harvested canine gallbladders were fused shut. Immediately after closure of the cystic ducts, bursting pressure was determined. Welding time was approximately 60 s. Mean bursting strengths immediately after closure were 207 mm Hg (+/- 94.3) in air (n = 10) and 202 mm Hg (+/- 44.7) under water immersion (n = 9). Histologic sectioning revealed a full-thickness denaturation of collagen fibers with fusion. Our preliminary investigations suggest that high-frequency electrical diathermy may provide practical advantages for fusion of biliary tissues when compared with conventional suture closure and laser fusion.