Endoscopic fetal surgery:in vitrothermic effect of electrosurgical units

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Abstract

Objective

The study focused on the safety of electrosurgical devices in endoscopic fetal surgery. The thermic effects of monopolar electric waves were studied in vitro in order to obtain safety indications in terms of mode of intramniotic application of electrical devices (time and number of shots; volts; and distance from tissues to be preserved).

Study design

A glass model filled with saline solution, and an electrical device with resistor and voltage supply, were constructed to reproduce the physical effects of thermic conductivity in vitro; a Swan-Ganz thermic sensor was used to measure the temperature inside the beuta. Different series of tests were carried out.

Results

The maximal increase (8.60 ± 0.04 °C) takes place at the external surface of the resistor (distance: 0 cm), while at 2 cm, the temperature of the saline solution does not change.

Conclusions

Our tests demonstrate that in order to avoid any kind of risk during electrosurgical procedures on fetuses, the electrode must be placed at least 0.5 cm from delicate tissues.

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