Minimal damage during endoscopic latissimus dorsi muscle mobilization withthe harmonic scalpel

Background. To reduce wound-related complications, a video-assisted surgica l technique has been adopted for the mobilization of the latissimus dorsi m uscle. We postulated that thermal damage to the muscle might be minimized b y using a Harmonic Scalpel instead of electrocautery during this procedure. Methods. Canine latissimus dorsi muscles were mobilized through a small inc ision, assisted by a videoscope. In 6 dogs, dissection with electrocautery was used to mobilize the latissimus dorsi muscle. In 6 other dogs, the Harm onic Scalpel was used. We compared operation times, wound infection rates, histologic changes in the muscles, and ease of handling between these group s. Results. The operation time was significantly shorter in the Harmonic Scalp el group Wan in the electrocautery group (61.5 versus 106.5 minutes, p = 0. 00014). The Harmonic Scalpel caused less histologic damage to the mobilized muscles and produced less vision-obscuring smoke. Conclusions. The Harmonic Scalpel shortens the operation, minimizes muscle damage, and facilitates the performance of video-assisted latissimus dorsi muscle mobilization. (C) 2000 by The Society of Thoracic Surgeons.