Showing papers on "Diathermy published in 2023"
TL;DR: In this article , a prospective comparative randomized study done over a period of 6 months (April 2022-September 2022) at GGH Vijayawada was conducted, where 60 patients were randomly divided into two groups of 30 each.
Abstract: INTRODUCTION Haemorrhoids are the most common anorectal disease seen in age group between 45-50 years. Milligan Morgan
haemorrhoidectomy is the gold standard operative procedure for grade 3 and grade 4 haemorrhoids.In the last decade high frequency sound wave
energy ultrasonic scalpel is used to cut and coagulate tissues in Milligan-Morgan haemorrhoidectomy. OBJECTIVE Our aim is to do a
comparative study between the outcomes of a Milligan Morgan haemorrhoidectomy by using ultrasonic scalpel versus diathermy cautery.
MATERIALS AND METHODS This is a prospective comparative randomized study done over a period of 6months (April 2022-September
2022) at GGH Vijayawada. 60 patients of age group 45-65 years. They were randomly divided into 2 groups of 30 each.
Group A – Underwent haemorrhoidectomy with diathermy cautery
Group B- Underwent haemorrhoidectomy with harmonic scalpel.
RESULTS Patients who underwent harmonic scalpel haemorrhoidectomy have statistically signicant P value in post operative pain , post op
urinary retention and anal stenosis. CONCLUSION Harmonic scalpel is better than diathermy in having relatively less post operative pain and
early resumption of daily activities and less occurrence of urinary retention and anal stenosis
TL;DR: In this article , the authors compared the operational time, blood loss and consequences of tonillectomy with ligasure versus bipolar diathermy and found that the ligasure group had less post-operative hemorrhages than the bipolar group.
Abstract: Aim: To compare the operational time, blood loss and consequences of tonsillectomy with Ligasure versus bipolar diathermy. Methods: A total of 106 individuals were randomized to have their Tonsillectomy done with either Ligasure or bipolar diathermy in this prospective trial. The length of procedure, amount of blood lost during it, degree of post-operative pain and the outcomes all were documented and studied. Results: In total, 106 cases were studied, with 53 cases in to the Ligasure Group and 53 cases to Bipolar Tonsillectomy Group. During surgery, bipolar diathermy group lost more amount of blood. The Ligasure group had an average operative time of 4 minutes less. Both groups had similar degrees of postoperative pain. Despite the fact that the Ligasure group had less postoperative hemorrhages than the diathermy group, there was no statistically significant difference. Conclusions: Study concluded that tonsillectomies using ligasure took longer than those with bipolar diathermy. Both groups had similar perioperative hemostasis. The rate of postoperative bleeding was higher than anticipated. Keywords: Ligasure, bipolar diathermy hemorrhage, hemostasis, blood loss during surgery
TL;DR: In this article , the authors proposed a method to solve the problem of the "missing link" problem in the context of artificial neural networks (ANNs) and the "hidden link".
Abstract: The Article Abstract is not available.
01 Jun 2023
TL;DR: Costa et al. as discussed by the authors used a sphincterotome-like device connected to diathermy with a 180 degree cutting wire to remove buried bumpers in the gastric wall.
Abstract:
Introduction
Buried bumper syndrome (BBS) occurs when the internal fixation of a percutaneous endoscopic gastrostomy (PEG) tube migrates outside of the stomach lumen along the stoma tract and becomes embeded in the gastric wall.1 It is a rare late complication which may result in loss of patency of the PEG, tube leakage and abdominal pain. There have been many non-surgical treatment options trialled in the past but none that have shown consistent results.1 The Flamingo device is a novel tool specifically designed to enable endoscopic removal of buried bumpers. This would reduce the risks associated with a GA and surgical removal as well as improving patient experience. It is a sphincterotome like device connected to diathermy with a 180 degree cutting wire. The overgrown granulation tissue is cut until the bumper is exposed and can be advanced into the stomach.2Methods
A retrospective data collection was performed for all patients with BBS in which the Flamingo procedure was attempted at our centre. We aimed to determine percentage success rate, average time of completion and whether a second PEG site was needed. We were also able to analyse the amount of sedation required for these procedures in comparison to GA needed for surgical removal.Results
12 Procedures were completed at Hospital A, a DGH, between June 2018 and October 2021. 11 of the patients were Male, 1 was female, with an age range of 41 to 88 years of age. 9 of the procedures were successful, a further 1 was successful on the second attempt and 2 needed surgical removal. The patient that needed to undergo a repeat procedure was agitated and desaturated after sedation and the procedure was abandoned. 1 patient was readmitted 4 days post procedure with sepsis secondary to cholecystitis. 1 Flamingo procedure was done under a general anaesthetic (GA). Average time of the procedure was 36mins. Average sedation use was 2mg Midazolam, (range 1–5mg) and 50mcg Fentanyl (range 25–75mcg).Conclusions
The Flamingo device offers a reliable and reproducible non-surgical technique for the treatment of BBS. As this is a co-morbid group of patients this is particularly beneficial in avoiding the potential risks associated with GA and surgical removal. We have shown that it can be done with minimal sedation and is both safe and less resource intensive than the traditional surgical techniques. It can be done as a day case procedure and helps to avoid hospital admissions which is beneficial both for patients and hospital trusts. The limitations of this study are the small sample size and relatively short study period.References
Costa D, et al. Multicenter cohort study of patients with buried bumper syndrome treated endoscopically with a novel, dedicated device. Gastrointest Endosc. 2021 Jun;93(6):1325–1332. doi: 10.1016/j.gie.2020.11.009. Epub 2020 Nov 19. PMID: 33221321. Costa D, Despott EJ, Lazaridis N, Koukias N, Murino A. Minimally invasive endoscopic management of buried bumper syndrome by use of a novel dedicated resection device. VideoGIE: an official video. Journal of the American Society for Gastrointestinal Endoscopy 2019;4(8):366–368.TL;DR: In this paper , a case report research method (case study) conducted on a frozen shoulder patient at Dr. Hardjono Ponorogo which was conducted in January 2023 was conducted to determine the appropriate physiotherapy management in frozen shoulder patients.
Abstract: Frozen shoulder or adhesive capsulitis is a condition in the form of pain and stiffness that occurs in the shoulder, usually this complaint is caused by a relatively small injury but the causes that often occur are unclear. Physiological problems in frozen shoulder are hypomobility or glenohumeral joint capsular pattern problems. The prevalence of frozen shoulder in Indonesia in the general population is reported to be around 2% with a prevalence of 11% in diabetics. The purpose of this study was to determine the appropriate physiotherapy management in frozen shoulder patients. With the case report research method (case study) conducted on a frozen shoulder patient at Dr. Hardjono Ponorogo which was conducted in January 2023. The results of the study found that physiotherapy interventions in the form of shortwave diathermy (SWD), Myofascial release, and active exercise which were carried out for 3 meetings showed results in the form of reduced pain, increased range of motion of joints, and increased functional ability patient. Keywords: Frozen Shoulder, Capsulitis adhesive, Shortwave diathermy, Myofascial release,active exercise
TL;DR: In this paper , the average postoperative pain in patients who underwent elective midline laparotomies at the Hayatabad Medical Complex Peshawar using either a scalpel or diathermy for incision was assessed.
Abstract: Background: During a laparotomy, the midline incision is frequently made with an electrocautery or scalpel. According to studies, there is no difference between these procedures' rates of complications. Aim : To assess the average postoperative pain in patients who underwent elective midline laparotomies at the Hayatabad Medical Complex Peshawar using either a scalpel or diathermy for incision. Methodology: This was a randomized controlled trial, which included 60 laparotomies patients who were divided into two groups at random. One group of patients had diathermy, whilst the other group underwent scalpel incisions. On the second postoperative day, a follow-up was conducted. Results: In diathermy group we had 63.3% males and 36.7% females while in the scalpel group we had 17 males and 13 females. 40% patients in diathermy group were hypertensive, this ratio was 36.7% in the scalpel group, diabetic patients were 26.7% in diathermy group and 16.7% in scalpel group. Practical implication: Cutting by diathermy is simpler, quicker, and results in less blood loss. Furthermore using diathermy to make an incision is no more likely to result in complications than using a scalpel Conclusion: For an elective laparotomy, skin incision with diathermy provides superior postoperative pain management than a scalpel. Keywords: Diathermy, incision, Laparotomy, woundpain, scalpel
TL;DR: In this article , the authors compared the effectiveness of US and microwave diathermy on knee OA patients' mobility and concluded that MWD therapy is better than US in improving mobility function of knee osteoarthritis.
Abstract: Osteoarthritis is a type of arthritis that is commonly found in the elderly and is the leading cause of pain in patients with knee osteoarthritis. Non-pharmacological therapy, such as ultrasound diathermy and microwave diathermy, is one of the treatment options. Thermal therapy and function in tissue regeneration, improving metabolic processes, and lowering inflammation of knee OA are two therapies that have something in common. The aim of the review is to compare the effectiveness of US and MWD on knee OA patients' mobility. analysis was carried out A literature study was conducted using several electronic medical journal databases, including PubMed-NCBI, ProQuest, Science Direct, and Google Scholar. Articles in English and Indonesian published between 2011–2021 qualify for inclusion. In this literature review, ten articles were used. The results of the review found that US and MWD have the same effectiveness in improving body function or mobility in knee OA patients. Six of the seven US articles showed effective results in improving the functional capacity of the body or mobility of knee OA. The three MWD articles also showed effective results in increasing the functional capacity of the body or the mobility of knee OA. Based on the average score of body functional parameters with WOMAC, TUGT, and stiffness, it can be concluded that MWD therapy is better than US in improving mobility function of knee OA
TL;DR: In this article , the authors analyzed the risk of postoperative hemorrhage in tonsil surgery with different surgical methods, instruments, indications, and age groups, and found that bipolar diathermy increased the risk for secondary bleedings compared to both monopolar diatherm and the cold steel with hot hemostasis technique in patients undergoing tonsillectomy.
Abstract: To analyze the risk of postoperative hemorrhage in tonsil surgery with different surgical methods, instruments, indications, and age groups. Monopolar diathermy compared to bipolar diathermy was of particular interest.The data from tonsil surgery patients were retrospectively collected between 2012 and 2018 in the Hospital District of Southwest Finland. The surgical method, instruments, indication, sex and age and their association with a postoperative hemorrhage were analyzed.A total of 4434 patients were included. The postoperative hemorrhage rate for tonsillectomy was 6.3% and for tonsillotomy 2.2%. The most frequently used surgical instruments were monopolar diathermy (58.4%) cold steel with hot hemostasis (25.1%) and bipolar diathermy (6.4%) with the overall postoperative hemorrhage rates 6.1%, 5.9% and 8.1%, respectively. In tonsillectomy patients, the risk for a secondary hemorrhage was higher with bipolar diathermy compared to both monopolar diathermy (p = 0.039) and the cold steel with hot hemostasis technique (p = 0.029). However, between the monopolar and the cold steel with hot hemostasis groups, the difference was statistically non-significant (p = 0.646). Patients aged > 15 years had 2.6 times higher risk for postoperative hemorrhage. The risk of a secondary hemorrhage increased with tonsillitis as the indication, primary hemorrhage, tonsillectomy or tonsillotomy without adenoidectomy, and male sex in patients aged ≤ 15 years.Bipolar diathermy increased the risk for secondary bleedings compared to both monopolar diathermy and the cold steel with hot hemostasis technique in tonsillectomy patients. Monopolar diathermy did not significantly differ from the cold steel with hot hemostasis group regarding the bleeding rates.
TL;DR: In this paper , a prospective non-randomized study, patients who underwent laparoscopic appendectomy (LA) for acute appendicitis were included, and the bipolar electrocautery was used for mesoappendix division in the first 33 patients (BC group), while the monopolar diathermy was used in the next 54 patients (MC group).
Abstract: There have been numerous techniques used in laparoscopic appendectomy (LA) to divide the mesoappendix, including LigaSure, Harmonic scalpel, clips, endoloop ligatures, Endo GIA staplers, and bipolar coagulation. However, few studies have investigated monopolar diathermy for mesoappendix division. Therefore, this study aimed to assess both its safety and efficacy in LA. In this prospective non-randomized study, patients (n = 87) who underwent LA for acute appendicitis were included. The bipolar electrocautery was used for mesoappendix division in the first 33 patients (BC group), while the monopolar electrocautery was used in the next 54 patients (MC group). The median operative time was significantly shorter in the MC group (42 min. vs 47 min. in BE group, p = 0.01). One patient converted to open surgery in the MC group due to uncontrollable bleeding. There were no significant differences between both groups regarding postoperative complications and hospital stay (p = 0.91, p = 0.13, respectively). Monopolar electrocautery is safe and effective for mesoappendix division in LP in comparison to bipolar electrocautery. However, larger and multicentric studies are required to validate our results.
TL;DR: In this article , a prospective, observational study included 30 sides from 24 patients who underwent chalazion surgery using diathermy thermocoagulation, and the chalaxion was not palpable in all cases 1 week post-operatively.
Abstract: To investigate the usefulness of diathermy thermocoagulation in chalazion surgery.This prospective, observational study included 30 sides from 24 patients who underwent chalazion surgery using diathermy thermocoagulation. The eyelid was fixed with a chalazion clamp under local anesthesia. The skin or palpebral conjunctiva was incised, and the chalazion was partially curetted. The residual chalazion contents were coagulated with diathermy and detached from the surrounding tissues using forceps and scissors. Then, the residual chalazion contents were completely removed.The chalazion was not palpable in all cases 1 week postoperatively. A small chalazion redeveloped close to the primary lesion 2 weeks postoperatively in one patient; however, it spontaneously improved. No other cases experienced recurrence or complication during the follow-up periods.Thermocoagulation of chalazion contents using diathermy facilitates grasp, dissection, and excision of chalazion contents.
TL;DR: In this paper , the effect of andiroba oil in preventing postoperative adhesions in the uterus and ovaries of sheep was evaluated with 15 days after surgical trauma, and the results showed that bipolar diathermy was able to cause POA in 75% of the sheep.
Abstract: Postoperative adhesions (POA) are postsurgical fibrinolytic connections that can cause complications, and alternative materials have drawn attention to their prevention. The aim of this study is to evaluate the effect of andiroba oil in preventing POA in the uterus and ovaries of sheep. Sixteen female Santa Inês adult sheep were randomly divided into two groups, a control group (CCG) with eight of them submitted to surgical trauma caused by bipolar diathermy in the uterine horn and right ovary without treatment to prevent POA and another group (AAG) with another eight ewes that underwent the same trauma, but were treated with the application of andiroba oil on the traumatized surfaces. Fifteen days after surgical trauma, the occurrence of POA and laparoscopic adesiolysis were evaluated. The bipolar diathermy was able to cause POA in 75% of the sheep. Bipolar diathermy caused POA in 100% of the CCG ewes and 50% of the AAG ewes. In CCG animals with adherence, in 25% of them, it was possible to perform adhesiolysis partially. Andiroba oil did not completely prevent the formation of postoperative adhesions in the uterus and ovaries of sheep, but it did prevent the formation of dense adhesions, facilitating laparoscopic adhesiolysis. Key words: Postoperative adhesiogenesis, laparoscopic adhesiolysis, reproductive tract, video surgery.
TL;DR: In this paper , the authors investigated the therapeutic effect of intensive inpatient therapy given to infants with CMT that involves the whole SCM using clinical measurements and ultrasound (US), and found that intensive in-patient therapeutic exercise and US diathermy with microcurrent may enhance the prognosis of CMT involving the entire SCM muscle.
Abstract: The efficacy and frequency of physiotherapy in the prognosis of congenital muscular torticollis (CMT) that involves the entire sternocleidomastoid (SCM) muscle continues to be unclear. This study investigated the therapeutic effect of intensive inpatient therapy given to infants with CMT that involves the whole SCM using clinical measurements and ultrasound (US). This study included 54 infants (27 boys and 27 girls; mean corrected age of 18.57 days) evaluated for CMT at our outpatient clinic from January 2014 to May 2021. The included patients were divided into three groups (groups 1, 2, and 3). Patients in group 1 underwent outpatient treatment 12 times. Patients in groups 2 and 3 underwent therapeutic exercise followed by US diathermy with microcurrent twice daily for 1 or 2 weeks, respectively. Passive range of motion of the cervical rotation (PCRROM) and SCM thickness were evaluated pre- and post-treatment. Among the three groups, the demographic data at baseline were not significantly different, SCM thickness and PCRROM were significantly decreased/increased at post-treatment compared to pre-treatment (p < 0.05), mean PCRROM change was significantly greater in group 3 (p < 0.05), and mean SCM thickness reduction between pre-treatment and 3 months post-treatment was significantly greater in groups 2 and 3 (p < 0.05). Therefore, intensive inpatient therapeutic exercise and US diathermy with microcurrent may enhance the prognosis of CMT involving the entire SCM muscle.
TL;DR: In this article , the difference between the two groups was assessed in terms of pain scores, slough separation time, duration of surgery and blood loss between two groups, and patients results showed statistical significant difference in the two classes in terms and pain scores.
Abstract: … Objective: To determine whether harmonic scalpel has any advantage over monopolar diathermy tonsillectomy or not in terms of blood loss, duration of surgery, pain scores and slough separation time. Study Design: Double Blind Cross Sectional study. Setting: Faisalabad Medical University and Affiliated Institutions. Period: April 2022 to September 2022. Material & Methods: Seventy patients were selected and divided by Random sampling into two groups to be operated either with Harmonic Scalpel or Monopolar Diathermy. The difference between the two groups was assessed in terms of pain scores, slough separation time, duration of surgery and blood loss between the two groups. Results: Patients results showed statistical significant difference in the two groups in terms of slough separation time and pain scores but there was no significant difference in terms of blood loss and duration of surgery. Conclusion: Harmonic scalpel does have an advantage over diathermy tonsillectomy as far as early healing is concerned and thus certainly helps in reducing the morbidity of the patients.
TL;DR: In this article , the authors compared the blood loss in bipolar diathermy versus suture ligation for hemostasis in patients presented with chronic tonsillitis, and concluded that bipolar dathermy group had statistically lower amount of blood loss and post-operative time when compared with ligation group.
Abstract: Objective: To compare the blood loss in bipolar diathermy versus suture ligation for hemostasis in patients presented with chronic tonsillitis Material and methods: We conducted this randomized controlled at ENT Department Sheikh Zayed Hospital Rahim Yar Khan from April, 2022 to September, 2022. Total 70 patients presenting with chronic tonsillitis divided in two groups equally. Patients were treated with two procedures bipolar diathermy and ligation. Mean blood loss and operative time was compared between both groups. T-Test was used for comparison keeping P < 0.05 as statistically significant. Results: Mean age of the patient was 22.86±9.31 years in group A and 22.89±7.29 years in group B. The mean blood loss in group A and group B was 27.71±7.10 ml vs 43.40±16.63 ml. Procedure time in group A and group B was 7.69±1.85 mins vs 9.91±2.09 mins. Conclusion: We conclude that bipolar diathermy group had statistically lower amount of blood loss and post-operative time when compared with ligation group. Keywords: bipolar diathermy, ligation, chronic tonsillitis, hemostasis
TL;DR: In this paper , the authors compared the outcome of diathermy versus scalpel skin incision in surgical cases, and found that the difference in the outcome between the two groups was significantly more among the scalpel group compared to the diathermmy group.
Abstract: Aim and Objectives: The present study compared the outcome of diathermy versus scalpel skin incision in surgical cases. Materials and Method: The present Prospective interventional study was done at Santosh Medical College & Hospital for a period of 1.5 years. Group A included 100 patients treated with Scalpel and Group B included 100 patients treated with Diathermy. Results: The mean Incision time (s), Incision time (s/cm2) and Pain VRS score at day 1 and 2 was significantly more among Scalpel group compared to Diathermy group. The mean Blood loss in incision (ml) was significantly more among Diathermy group compared to Scalpel group. Conclusion: Due to shorter incision times, less blood loss, and less early postoperative discomfort, diathermy incisions have substantial benefits over scalpels in both elective and emergency general surgery.
TL;DR: In this article , the effect of acute diathermy, a heating modality, on leg blood flow and endothelial function was examined, and it was found that diatherm treatment would increase leg flow compared to baseline, as measured by peak increase in blood flow during passive leg movement.
Abstract: Endothelial dysfunction is a common predecessor of many cardiovascular diseases. Heat therapy has been shown to improve cardiovascular health by stimulating changes within the endothelium. The purpose of this study was to examine the effect of acute diathermy, a heating modality, on leg blood flow and endothelial function. We hypothesized that diathermy treatment would increase leg blood flow compared to baseline, as well as increase endothelial function, as measured by peak increase in blood flow during passive leg movement. Nine healthy, young subjects (4 males, 5 females; mean (± SD) age = 23 ± 3.2 years, height = 174.8 ± 9.6 cm, mass = 74 ± 11.5 kg, body mass index = 24.1 ± 1.2) with no history of cardiovascular disease volunteered for this study. Subjects underwent 100 minutes of diathermy treatment on the vastus lateralis of a single, randomly assigned leg. Blood flow was measured at the common femoral artery using a Doppler ultrasound before, immediately after, and 30 minutes after heating. Passive leg movement was performed on the subjects before heating, and 30 minutes post-heating and peak blood flow was measured using Doppler ultrasound. Blood flow was found to significantly increase 20.4% from baseline to immediately post-heating (baseline, 355.3 ± 145.7 mL·min-1, immediately post, 428 ± 111.1 mL·min-1, p=0.045), and returned to baseline 30 minutes post-heating (30 min post, 361 ± 101.3 mL·min-1, p=0.853). Additionally, peak leg blood flow during passive leg movement significantly increased by 19.8% from baseline to 30 minutes post-heating (baseline, 1046.4 ± 379 mL·min-1, 30 min post, 1253.4 ± 430.2 mL·min-1, p=0.029). In conclusion, both leg blood flow and endothelial function, assessed by peak leg blood flow, significantly increased from baseline following 100 minutes of diathermy treatment. These data provide evidence for the benefits of acute diathermy treatment in improving leg vascular function via enhancements to endothelial function. This is the full abstract presented at the American Physiology Summit 2023 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.
TL;DR: In this article , the frequency of post-operative hemorrhage and type of management employed following tonsillectomy performed with bipolar diathermy was studied and the results showed that post-tonsillectomysmography is comparatively a common complication occurring with bipolar dathermy and it is important for the surgeon to be vigilant of this fact for timely and appropriate management.
Abstract: Objectives: To study the frequency of post-operative hemorrhage and type of management employed following tonsillectomy performed with bipolar diathermy.Study Design: Descriptive cross-sectional study.Place and Duration of Study: The study was carried out at the Department of ENT of Combined Military Hospital, Rawalpindi, Pakistan from February 2021 to January 2022.Materials and Methods: We studied 66 patients who were selected for tonsillectomy. Patients having a previous record of pharyngeal surgery and thrombotic disorders/ hemorrhagic diathesis were excluded. All participants underwent tonsillectomy with bipolar diathermy and were followed up 10 days for the development of post-tonsillectomy hemorrhage. Data were analyzed by SPSS 26.0.Results: A total of 10 (15.2 %) patients developed post-tonsillectomy hemorrhage in our study. Of these, 8 (12.2 %) were managed conservatively while 2 (3.0%) required surgical management to control hemorrhage. Blood transfusion was required by 1 (1.5%) patient.Conclusion: Post-tonsillectomy hemorrhage is comparatively a common complication occurring with bipolar diathermy. It is important for the surgeon to be vigilant of this fact for timely and appropriate management in this scenario.
TL;DR: In this article , a prospective randomised controlled trial aimed to assess whether using LigaSure improved perioperative outcomes when compared with monopolar diathermy alone in performing mastectomy without axillary dissection.
Abstract:
LigaSure is an electrothermal bipolar vessel-sealing system shown to decrease blood loss and drainage volume compared to electrocautery in axillary node dissection. This prospective randomised controlled trial aimed to assess whether using LigaSure improved perioperative outcomes when compared with monopolar diathermy alone in performing mastectomy without axillary dissection.
Mastectomy was performed with the LigaSure device and compared with mastectomy using conventional monopolar diathermy in a prospective randomised trial. Patients were recruited over 39 months and were aged from 33 to 86 years of age. Block randomisation (44 in the Ligasure group and 42 in the diathermy group) was performed. The primary outcome measures include total volume in drain output (ml), time to drain volume less than 30mls in 24 hours and operating time.
Drain output volume was measured to the day the drain yielded less than 30mls in a 24 hour period in both groups (484 mls in the monopolar group v 494 mls in Ligasure group). This time point was also used to calculate time to drain removal in both groups (Monopolar 7.2 days and Ligasure 7.3 days). Drain output volume and number or days to drain removal did not show any significant difference in both groups (p=0.05). The operative time in both groups was similar (106mins in monopolar group and 112.5 mins in LigaSure group).
Use of the LigaSure device is feasible in performing mastectomy. It is not associated with reduced drain volume or shorter operative time compared with monopolar diathermy.
TL;DR: A 10-year old girl was referred with the complaints of “per vaginal bleeding and a mass after cycling”. During the first 2 weeks of symptoms, she had visited three different doctors with possible delayed recognition of her diagnosis as mentioned in this paper .
Abstract: A 10 years old girl was referred with the complaints of “per vaginal bleeding and a mass after cycling”. During the first 2 weeks of symptoms, she had visited three different doctors with possible delayed recognition of her diagnosis. Clinical examination revealed an underweight, non-dysmorphic, prepubertal girl with vulvitis and an inflamed interlabial bleeding mass with ulceration. Imaging revealed a subcentimetre arteriovenous fistula and haematoma in the vagina. After one more week (total 3 weeks) of medical therapy, the indication for surgery was worsening of symptoms and failure of medical management. Examination under anaesthesia and cystoscopy revealed a complete urethra prolapse. Dilute adrenaline was injected into the prolapsed mucosa. The prolapse was excised in elliptical segments, and the edges closed with interrupted absorbable sutures. Sub-centimetre segments of mucosa were left between the excised specimens. Bipolar diathermy was used only for hemostasis and circumferential coagulation on the mucosa was avoided. These measures prevent an iatrogenic stenosis. The urethra prolapse was reduced, with no recurrence demonstrated on Valsalva maneuver. Post-operatively, her symptoms resolved. Oral antibiotics, sitz baths, antimicrobial cream and topical estrogen were administered. There was no recurrent urethra prolapse or stricture. The aim of this case report is to increase awareness of the urethral prolapse in the paediatric population and its management.
TL;DR: The use of electrocautery for making skin incisions in midline abdominal surgery was associated with less intraoperative blood loss and less incision time as compared to a scalpel as mentioned in this paper .
Abstract: The scalpel was considered a gold standard for making skin incisions until the inception of diathermy. Nowadays, electrodes used in making diathermy incisions generate a pure sinusoidal current which produces cleavage in the tissue planes without creating damage to surrounding areas, thus leading to minimal burn-related wound complications.4 Hence, this study was carried out to determine whether electrocautery is safe and effective for making skin incisions as compared to a scalpel for midline abdominal surgery.
OBJECTIVE: The object of the study was to compare electrocautery incision with scalpel incision in terms of incision time, blood loss, postoperative pain and wound infection. The objective was to determine whether electrocautery is safe and effective for making skin incisions as compared to a scalpel for midline abdominal surgery.
Methodology: Patients scheduled for midline abdominal surgeries and willing to participate in the study were randomized into two groups- group A (electrocautery group) and group B (scalpel group).
Results: In this study, 52 patients were included and divided into two groups, of which 26 were in group A and 26 were in group B. Intraoperative blood loss and incision time are less while using electrocautery as compared to a scalpel. In terms of postoperative pain and wound complications, there was no discernible variance between the two groups.
Conclusion: The use of electrocautery for making skin incisions in midline abdominal surgery was associated with less intraoperative blood loss and less incision time as compared to a scalpel. There was no variance in postoperative pain and wound complications between the two groups. With the above advantages of electrocautery, we conclude that electrocautery is a safe and effective alternative to a scalpel in making skin incisions in midline laparotomy.
TL;DR: In this article , the authors conducted a systematic review according to the PRISMA statement and Cochrane Handbook 6.3 to evaluate the effect of electromagnetic diathermy therapies (e.g., shortwave, microwave, capacitive resistive electric transfer) on musculoskeletal disorders.
Abstract: OBJECTIVE: This study aims to establish the effect of electromagnetic diathermy therapies (e.g., shortwave, microwave, capacitive resistive electric transfer) on pain, function, and quality of life in treating musculoskeletal disorders. METHODS: We conducted a systematic review according to the PRISMA statement and Cochrane Handbook 6.3. The protocol has been registered in PROSPERO: CRD42021239466. The search was conducted in PubMed, PEDro, CENTRAL, EMBASE, and CINAHL. RESULTS: We retrieved 13,323 records; 68 studies were included. Many pathologies were treated with diathermy against placebo, as a standalone intervention or alongside other therapies. Most of the pooled studies did not show significant improvements in the primary outcomes. While the analysis of single studies shows several significant results in favour of diathermy, all comparisons considered had a GRADE quality of evidence between low and very low. CONCLUSIONS: The included studies show controversial results. Most of the pooled studies present very low quality of evidence and no significant results, while single studies have significant results with a slightly higher quality of evidence (low), highlighting a critical lack of evidence in the field. The results did not support the adoption of diathermy in a clinical context, preferring therapies supported by evidence.
25 Apr 2023
TL;DR: In this paper , a systematic review and meta-analysis of the randomized controlled trials (RCTs) to comprehensively evaluate the efficacy of harmonic scalpel (HS) versus bipolar diathermy (BD) methods in terms of decreasing intraoperative and postoperative morbidities among patients undergoing hemorrhoidectomy was carried out.
Abstract: Hemorrhoidectomy is one of the most common surgical interventions to remove the third and fourth degrees of prolapse hemorrhoid. We carried out this systematic review and meta-analysis of the randomized controlled trials (RCTs) to comprehensively evaluate the efficacy of harmonic scalpel (HS) versus bipolar diathermy (BD) methods in terms of decreasing intraoperative and postoperative morbidities among patients undergoing hemorrhoidectomy. Suitable citations were found utilizing digital medical sources, including the CENTRAL, Web of Science, PubMed, Scopus, and Google Scholar, from inception until December 2022. Only RCTs that matched the inclusion requirements were selected. We used the updated Cochrane risk of bias (ROB) tool (version 2) to assess the quality of the involved citations. The Review Manager (version 5.4 for Windows) was used to perform the pooled analysis. Data were pooled and reported as mean difference (MD) or risk ratio (RR) with a 95% confidence interval (CI) in random-effects models. Overall, there was no significant difference between HS and BD in terms of decreasing intraoperative morbidities like operative time, intraoperative blood loss, mean duration of hospital stay, and mean duration of first bowel movement (P>0.05). Similarly, the rate of postoperative complications like pain, bleeding, urinary retention, anal stenosis, flatus incontinence, and wound edema; was similar in both groups with no significant difference (P>0.05). In conclusion, our pooled analysis revealed there was no substantial difference between HS and BD in terms of intraoperative and postoperative endpoints. Additional RCTs with larger sample sizes are needed to consolidate the power and quality of the presented evidence.
TL;DR: In this article , the safety, feasibility and long-term outcomes of laparoscopic common bile duct exploration (LCDBE) using electrosurgery (coagulation) for choledochotomy followed by primary closure after endoscopic treatment failure were evaluated.
Abstract:
Choledocholithiasis is a frequent pathology, unfortunately when its endoscopic management fails there is no consensus on how it should be addressed. The aim of this study was to evaluate the safety, feasibility and long-term outcomes of laparoscopic common bile duct exploration (LCDBE) using electrosurgery (coagulation) for choledochotomy followed by primary closure after endoscopic treatment failure.
A retrospective cohort of 168 patients who underwent LCDBE from 2013 to 2018 which was conducted all by choledochotomy. Clinical demographics, operative outcomes, recurrence rate of CBD stones, and long-term bile duct complications were analyzed.
The male/female ratio was 90/78 and mean age was 73 years. Stone clearance was successful in 167 patients (99.4%). Nonlethal complications were noted in 3 patients during the surgery or in the immediate postoperative (1.79%) and managed with T-tube or endoscopically. No cases of surgery-related mortality were observed. There were no signs of any type of biliary injury or stricture observed in any of the patients during the 24-month follow-up period.
LCBDE through choledochotomy with diathermy and primary closure can be performed without increased risk of operative complications such as important and visual-impairment bleeding as well as long-term complications such as bile duct stricture or recurrent CBD stones. LCBDE with diathermy and primary closure is a safe and effective treatment option for choledocholithiasis for failed ERCP in terms of long-term outcome as well as short-term outcome.
TL;DR: In this article , the feasibility and efficacy of lateral anal sphincterotomy for chronic anal fissure under local anaesthesia using diathermy as an outpatient procedure was evaluated.
Abstract: Anal fissure is one of the most common surgical disorders of the anal canal, ranking next to hemorrhoids and chronic constipation. The incidence of anal fissure has been increasing since the last two decades due to irregular foot habits as well as improper modern lifestyle habits. The prevalence of anal fissure in general population is probably much more higher than that is seen in clinical practice. This is because ,most of the patients do not seek medical attention or resort to some form of native treatment. In early stages, it can be managed by increasing intake of dietary fibres, stool softeners and Sitz baths .But chronic fissure in ano needs surgical treatment, as the underlying pathology is increased internal anal sphincter tone. Lateral anal sphincterotomy is the procedure of choice, which is usually performed under regional anaesthesia. This procedure can also be performed under local anaesthesia as a day care procedure with similar results. This study aims to determine the feasibility and efficacy of lateral anal sphincterotomy for chronic anal fissure under local anaesthesia using diathermy as an outpatient procedure.
TL;DR: In this paper , the authors evaluated Jordanian physiotherapists' knowledge of pulsed and continuous shortwave diathermy contraindications and investigated the potential contrain-dications about which Jordanian physiotherapy may have limited knowledge.
Abstract: It is known that electromagnetic fields and heat generated by shortwave diathermy (SWD) can have adverse effects on living tissue. The purpose of this research is to evaluate Jordanian physiotherapists' knowledge of pulsed and continuous SWD contraindications. And investigate the potential contraindications about which Jordanian physiotherapists may have limited knowledge.This cross-sectional study investigates Jordanian physiotherapists' knowledge of SWD contraindications. In 38 private and public hospitals, a self-administered questionnaire survey was carried out. Participants were asked to classify 32 conditions as "always, sometime, or never" contraindicated or "I do not know". Participants are physiotherapists with two or more years of postgraduate experience. Two forms comprised the survey. The first consisted of assessing their reaction to the contraindications of pulsed shortwave diathermy (PSWD), while the second consisted of continuous shortwave diathermy (CSWD).Approximately 270 physiotherapists were eligible to participate in this investigation. Only 150 questionnaires were distributed to the therapists who agreed to the study. One hundred twenty-eight were returned for an average response rate of 85.3% (128/150). Respondents had good agreement about using SWD for cardiovascular condition, however, 24 respondents (19%) thought PSWD can be used over venous thrombosis. Only 64% of the respondents was aware that pacemakers are contraindicated for PSWD. Approximately 14% to 32% seem unaware that tuberculosis and osteomyelitis are contraindicated for both CSWD and PSWD. About 21% to 28% have been unaware that the use of PSWD is contraindicated for specialized tissues (eg, eyes, gonads, or malignant tissues) and 29% during pregnancy.Jordanian physiotherapists generally agreed on the widely acknowledged contraindications of CSWD for specific conditions. However, there was considerable uncertainty among Jordanian physical therapists about the contraindications of PSWD. This discrepancy highlights the need to improve physiotherapist awareness and for more fact-based research to the contraindication of SWD modality.