COMPARISON OF THE ULTRASONIC SCALPEL TO CO2-LASER AND ELECTROSURGERY IN TERMS OF TISSUE-INJURY AND ADHESION FORMATION IN A RABBIT MODEL

Objective: To determine the relative effect of an ultrasonic scalpel o n reproductive tissue compared with CO2 laser and electrosurgery. Desi gn: Prospective, randomized animal study. Setting: University laborato ry setting. Animals: Sixteen New Zealand White rabbits. Intervention(s ): A steel scalpel, an ultrasonic scalpel, a CO2 laser, or electrosurg ery were used to perform an ovarian wedge resection and to remove the distal uterine horn. A 3-cm longitudinal incision also was made in the uterine horn. Main Outcome Measure(s): The number of 1-second bursts of needle-tip electrosurgery required for hemostasis, the depth and de gree of coagulation necrosis, degree of fibrin deposition, and postope rative adhesion formation. Result(s): The amount of electrosurgery nee ded to achieve hemostasis was less for any of the four power technique s than for the steel scalpel, with the exception of the ultrasonic sca lpel at level 5 when used on the ovary. The depth (range: 0.30 to 0.38 mm) and the degree of coagulation necrosis was not different for ally of the power techniques. The fibrin score was greatest for the ultras onic scalpel at level 5 in both the ovarian tissue and the uterine tis sue. There was no difference in adhesion scores for the power techniqu es and the steel scalpel. Conclusion(s): The ultrasonic scalpel at lev el 3 is not different from either CO laser or electrosurgery in terms of hemostatic properties, coagulation necrosis, or adhesion formation in the rabbit model.