Bipolar coagulation with small diameter forceps in animal models for in-utero cord obliteration

The objective of this study was to evaluate the feasibility, efficacy and s afety of bipolar coagulation using endoscopic forceps of diameters of 2.7 m m and less in animal models mimicking in-utero conditions. Forceps of 2.2, 2.3, 2.5 and 2.7 mm were tested in rabbits(n = 36). Vessel pairs were disse cted and coagulated in a fluid environment under endoscopic vision at 15 an d 25 W. The main outcome measure was the perforation rate, In fetal lambs ( n = 25), umbilical cords were coagulated under sono-endoscopic control with power settings from 10 to 35 W, Main outcome measures were the duration of coagulation, perforation rate, change in the temperature of the amniotic f luid and efficacy of vessel occlusion rate. At 20-25 W, all cords were coag ulated successfully without any perforation using 2.3, 2.5 or 2.7 mm forcep s, Coagulation with the 2.2 mm forceps was associated with a high perforati on rate, although the design rather than the diameter of the forceps may ha ve influenced this outcome. Bipolar coagulation with forceps between 2.3 an d 2.7 mm and appropriate power settings achieves efficacious and safe coagu lation in animal models for umbilical cord occlusion.