Randomized experimental study to investigate the peritoneal adhesion formation of conventional monopolar contact coagulation versus noncontact argon plasma coagulation in a rat model

Conventional monopolar contact coagulation induces significantly more adhesions that are more vascularized than noncontact argon plasma in a randomized experimental rodent model.

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Authors

Bernhard Kraemer, M.D., Marcus Scharpf, M.D., Constanze Planck, M.D., Christos Tsaousidis, M.D., Markus D. Enderle, M.D., Alexander Neugebauer, Ph.D., Kristin Kroeker, Ph.D., Falko Fend, M.D., Sara Brucker, M.D., Ralf Rothmund, M.D.

Volume 102, Issue 4, Pages 1197-1202

Abstract

Objective:

To investigate peritoneal adhesion formation of monopolar contact coagulation (MCC) versus noncontact argon plasma coagulation (APC) in a rat model.

Design:

Prospective, randomized, controlled, single-blinded animal study.

Setting:

University laboratory.

Animal(s):

Sixteen female Wistar rats.

Intervention(s):

Bilateral lesions were created on the abdominal wall with MCC and APC in a standard fashion. After 10 days, the rats were euthanized to evaluate the peritoneal trauma sites.

Main Outcome Measure(s):

Adhesion incidence, quantity, and quality were scored 10 days postoperatively and studied histopathologically.

Result(s):

Average energy intake was 99.5 ± 7.39 J for APC and 95.7 ± 9.62 J for monopolar contact coagulation. Incidence of adhesion formation was 50.0% for noncontact APC and 85.4% for MCC. MCC induced significantly more vascular adhesions. Histological evaluation revealed no significant differences regarding average depth of lesions induced by APC and MCC. Both groups showed almost identical morphology of necrosis and granulation tissue formation.

Conclusion(s):

This study compares for the first time adhesion formation of MCC versus noncontact APC in a rat model. With a similar energy intake, contact coagulation induced a significantly higher rate of adhesion formation. APC-induced adhesions were significantly less vascularized compared with MCC adhesions. Besides the thermal effects of both coagulation methods, the direct mechanical contact of the MCC electrode with the highly sensitive peritoneum is thus determined to be a pivotal additional stimulus for adhesion formation.

Read the full text at: http://www.fertstert.org/article/S0015-0282(14)00602-5/fulltext


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Fertility and Sterility® is an international journal for obstetricians, gynecologists, reproductive endocrinologists, urologists, basic scientists and others who treat and investigate problems of infertility and human reproductive disorders. The journal publishes juried original scientific articles in clinical and laboratory research relevant to reproductive endocrinology, urology, andrology, physiology, immunology, genetics, contraception, and menopause. Fertility and Sterility® encourages and supports meaningful basic and clinical research, and facilitates and promotes excellence in professional education, in the field of reproductive medicine.

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