Jd. Harrison et Dl. Morris, ARTERY WELD STRENGTH AFTER BIPOLAR ELECTROCOAGULATION IS AFFECTED BY ELECTROLYTE-SOLUTIONS AROUND THE ARTERY, Gastrointestinal endoscopy, 39(4), 1993, pp. 546-548
We have recently shown that artery weld strength is significantly incr
eased by increasing bipolar electrocoagulation time in fresh rabbit ar
teries, which had either 2 or 20 seconds of electrocoagulation under u
niform conditions. In this study we investigated the effect of using e
ither distilled water or physiologic saline around the artery during e
lectrocoagulation in a total of 27 experiments, because it is the curr
ent practice to wash clot and liquid blood off bleeding ulcers with wa
ter. Fresh rabbit arteries were used, with a bipolar coagulation time
of 2 seconds, with a constant weight of 500 gm applied to the head of
the probe to standardize conditions. The bursting pressure of the coag
ulum was determined by cannulating the artery and increasing the press
ure until the coagulum seal fractured. The artery weld strength was si
gnificantly lower when distilled water was used (median, 87.5 mm Hg; r
ange, 10 to 225 mm Hg) compared with results when normal saline was us
ed (median, 150 mm Hg; range, 100 to 850 mm Hg); by Mann-Whitney tests
U = 42.5, Z = 2.36, and p = 0.018. These data suggest that more effec
tive hemostasis of bleeding arteries may be achieved by not only more
prolonged use of the diathermy probe, but also by using physiological
saline as the washing solution instead of water, as is currently pract
iced.