Abstract
Objective: Oncological surgical technological innovation has produced alternative hemostatic dissection techniques. Collateral tissue destruction and impact upon assessment of tumor resection margins from Harmonic and Coblation dissectors remains unknown. This study uses an ex-vivo animal model to quantify the collateral tissue destruction caused by the harmonic scalpel vs coblator wand dissection.
Method: Incisions through cow tongue were made between defined parallel lines with each dissection technique. The residual tissue width was measured with vernier calipers and subtracted from the width of original tissue. A scalpel blade was used as a control.
Results: The mean width of collateral tissue destruction for each modality was as follows: harmonic cutting 3.0 mm, harmonic coagulating 4.1 mm, coblation cutting 3.5 mm, harmonic cutting under tissue tension 1.2 mm.
Conclusion: This study demonstrates that tissue destruction produced when using the harmonic scalpel and coblation is significant when compared to cold steel dissection. The findings of this study should be borne in mind when using the harmonic scalpel and coblation in oncological surgery and making decisions regarding postoperative adjuvant therapy.
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