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Surgical diathermy is not suitable for vascular tissue welding
1Professorial Surgical Unit, St Bartholowmew's Hospital, London.
Journal of the Royal Army Medical Corps
|October 1, 1994
Summary
Radiofrequency energy (RFE) cannot yet create reliable sutureless vascular welds. This study found RFE at 500 kHz produced weak vascular tissue welds, unsuitable for surgical applications.
Area of Science:
- Vascular Surgery
- Biomedical Engineering
- Electrosurgery
Background:
- Sutureless anastomosis using radiofrequency energy (RFE) offers potential benefits in military surgery, cost-effectiveness, and simplicity.
- Current surgical techniques often rely on sutures, which can be time-consuming and prone to complications.
Purpose of the Study:
- To evaluate the efficacy of radiofrequency energy (RFE) in creating sutureless vascular anastomoses.
- To determine the mechanical strength of RFE-welded vascular tissue compared to intact and sutured tissues.
Main Methods:
- Fresh rabbit aorta strips (4 mm) were apposed intima-to-intima.
- Radiofrequency energy (500 kHz) was applied using a Valleylab Force 30 Electrosurgery machine and bipolar forceps.
- 121 attempts were made to weld the tissue; resulting welds were tested for distraction force.
Main Results:
- Out of 121 attempts, 77 welds were achieved.
- Only 36 welds withstood a distraction force greater than 0.1N, with the strongest failing at 0.35N.
- Intact aorta withstood >2N, while sutured joints failed at 0.97N, indicating significantly weaker RFE welds.
Conclusions:
- Radiofrequency energy at 500 kHz is not a satisfactory method for welding vascular tissue.
- The mechanical strength of RFE-welded vascular tissue is insufficient for surgical anastomosis.
- Further research is needed to improve RFE welding techniques for vascular applications.
