PMID- 10653244
OWN - NLM
STAT- MEDLINE
DCOM- 20000210
LR  - 20230320
IS  - 1432-2218 (Electronic)
IS  - 0930-2794 (Linking)
VI  - 14
IP  - 1
DP  - 2000 Jan
TI  - Ultrasonic coagulator for video-assisted internal mammary artery harvest.
PG  - 82-5
AB  - BACKGROUND: The Harmonic Scalpel (HS; Ethicon Endo-Surgery, Cincinnati, OH, USA) 
      is an ultrasonic coagulator that generates less heat than electrocautery. We 
      compared canine internal mammary arteries (IMAs) harvested using the HS or 
      electrocautery and reviewed the early clinical outcome after thoracoscopic IMA 
      takedown with the HS. METHODS: Using HS and bipolar electrocautery (BE), 51 and 
      49 IMA branches, respectively, in six mongrel dogs were divided. The divided 
      branches were subjected to a pressure tolerance test. The impact of coagulation 
      on the main trunk was investigated microscopically. Thoracoscopic IMA harvesting 
      with the HS was performed in 41 patients. Seven human IMA segments including 10 
      branches were examined microscopically. Postoperative angiography of 40 IMA 
      grafts (97.6%) was performed. RESULTS: All the IMA branches withstood 
      intraluminal pressures up to 250 mmHg. With BE, coagulation reached the 
      adventitia of the main trunk in six segments (12.2%), but the HS caused no 
      injury. Thoracoscopic IMA harvesting with excellent hemostasis was achieved using 
      only the HS in all 41 patients. The main trunks of the human IMA segments were 
      microscopically intact, and postoperative angiography demonstrated that the IMA 
      grafts were intact. CONCLUSION: The HS appears to be a reliable coagulator for 
      thoracoscopic IMA harvesting with minimal damage.
FAU - Ohtsuka, T
AU  - Ohtsuka T
AD  - Department of Cardiothoracic Surgery, University of Tokyo, Japan.
FAU - Takamoto, S
AU  - Takamoto S
FAU - Endoh, M
AU  - Endoh M
FAU - Kotsuka, Y
AU  - Kotsuka Y
FAU - Oka, T
AU  - Oka T
LA  - eng
PT  - Journal Article
PL  - Germany
TA  - Surg Endosc
JT  - Surgical endoscopy
JID - 8806653
SB  - IM
MH  - Animals
MH  - Coronary Artery Bypass/instrumentation/methods
MH  - Dogs
MH  - Electrocoagulation
MH  - Female
MH  - Hemostasis, Surgical/*instrumentation
MH  - Humans
MH  - Male
MH  - Mammary Arteries/*surgery
MH  - Middle Aged
MH  - *Thoracoscopy
MH  - *Ultrasonics
MH  - Video Recording
EDAT- 2000/02/01 00:00
MHDA- 2000/02/01 00:01
CRDT- 2000/02/01 00:00
PHST- 2000/02/01 00:00 [pubmed]
PHST- 2000/02/01 00:01 [medline]
PHST- 2000/02/01 00:00 [entrez]
AID - 10.1007/s004649900018 [doi]
PST - ppublish
SO  - Surg Endosc. 2000 Jan;14(1):82-5. doi: 10.1007/s004649900018.