Full-text resources of PSJD and other databases are now available in the new Library of Science.
Visit https://bibliotekanauki.pl


Preferences help
enabled [disable] Abstract
Number of results
2011 | 83 | 7 | 355-360

Article title

Comparison of Lateral Thermal Spread Using Monopolar and Bipolar Diathermy, and the Bipolar Vessel Sealing System ThermoStapler™ During Thyroidectomy


Title variants

Languages of publication



Electric devices enabling the maintenance of haemostasis during surgery have found application in modern thyroidectomy procedures. The haemostatic effect is associated with generation of heat, which apart from the intended result may bring about thermal tissue injury.The aim of the study was to determine the thermal spread around the active tip of electric devices in the operating field during total thyroidectomy, and the safe temperature range during the operation of studied devices.Materials and methods. Over 14 months from December 2009 until January 2011, 76 total thyroidectomy procedures were analysed. The surgeries employed mono- and bipolar diathermy as well as the ThermoStapler™ bipolar vessel sealing system. During the procedures, the thermal spread around the active tips of used electric devices was recorded with the use of high-definition camera. Comparable 5-second periods of electric device use at two power ranges (30 W and 50 W) were selected from the recorded material. The highest temperature of the active tip of electric devices was determined, and the 42°C isotherm was found with the use of computer image analysis, thus determining the safe distance of important anatomic structures from the active tip of the electric device.Results. The temperature spread around the active tips of electric devices was recorded and the 42°C isotherm was determined. The diameter of this isotherm at the end of operation differed statistically significantly depending on the type of electric devices and power settings. The highest temperature, at both power ranges, was recorded for the bipolar vessel sealing system, while the lowest - for bipolar diathermy; at the same time a significantly lower 42°C isotherm diameter was found for ThermoStapler™ as compared with other devices. In all studied cases, the largest heat spread was found for monopolar diathermy.Conclusions. The mean safe distance of the active tip of an electric device from important anatomic structures is 5 mm and depends on the device type and its power settings. Monopolar diathermy causes the strongest heating of surrounding tissues, and the ThermoStapler™ bipolar vessel sealing system, despite producing the highest temperature during operation, causes relatively small thermal injury to the surrounding tissues.









Physical description


1 - 7 - 2011
21 - 9 - 2011


  • Department of General, Oncological and Endocrine Surgery Medical University in Łódź, Polish Mother Memorial Hospital - Research Institute
  • Laser Diagnostics and Therapy Centre of the Technical University in Łódź
  • Department of General, Oncological and Endocrine Surgery Medical University in Łódź, Polish Mother Memorial Hospital - Research Institute
  • Department of General, Oncological and Endocrine Surgery Medical University in Łódź, Polish Mother Memorial Hospital - Research Institute
  • Department of General, Oncological and Endocrine Surgery Medical University in Łódź, Polish Mother Memorial Hospital - Research Institute


  • Sutton PA, Awad S, Perkins AC et al.: Comparison of lateral thermal spread using monopolar and bipolar diathermy, the Harmonic Scalpel and the LigaSure. Br J Surg 2010 Mar; 97(3): 428-23.
  • Manouras A, Markogiannakis H, Koutras AS et al.: Thyroid surgery: comparison between the electrothermal bipolar vessel sealing system, harmonic scalpel, and classic suture ligation. Am J Surg 2008 Jan:195(1): 48-52.[WoS]
  • Sartori PV, De Fina S, Colombo G et al.: Ligasure versus Ultracision in thyroid surgery: a prospective randomized study. Langenbecks Arch Surg 2008 Sep; 393(5): 655-58.
  • Miccoli P, Materazzi G, Miccoli M, et al.:. Evaluation of a new ultrasonic device in thyroid surgery: comparative randomized study. Am J Surg 2010 Jun 199(6): 736-40.
  • Scerrino G, Paladino NC, Di Paola V et al.: Total thyroidectomy performed with the Starion vessel sealing system versus the conventional technique: a prospective randomized trial. Surg Innov 2010 Sep; 17(3): 242-47.[Crossref][PubMed][WoS]
  • Kennedy JS, Stranahan PL, Taylor KD et al.: Highburst-strength, feedback-controlled bipolar vessel sealing. Surg Endosc 1998 Jun; 12(6): 876-78.[Crossref][PubMed]
  • Harold KL, Pollinger H, Matthews BD et al.: Comparison of ultrasonic energy, bipolar thermal energy, and vascular clips for the hemostasis of small-, medium-, and large-sized arteries. Surg Endosc 2003 Aug; 17(8): 1228-30.[PubMed]
  • Campbell PA, Cresswell AB, Frank TG et al.: Real - time thermography during energized vessel sealing and dissection. Surg Endosc 2003 Oct; 17(10): 1640-45.[Crossref][PubMed]
  • Clark OH, Duh QY, Kebebew E: Textbook of endocrine surgery. Lennquist S Thyroidectomy. Elsevier, Philadelphia 2006; s. 188-94.
  • Gemsenjaeger E: Atlas of Thyroid Surgery. Wyd. 1 Thieme Georg Verlag 2008.
  • Sunderland S: A classification of peripheral nerve injuries producing loss of function. Brain 1951; 74(4): 491-516.
  • Pattou F, Combemale F, Fabre S et al.: Hypocalcemia following thyroid surgery: incidence and prediction of outcome. World J Surg 1998 Jul; 22(7): 718-24.[PubMed][Crossref]
  • Smith CT, Zarebczan B, Alhefdhi A et al.: Infrared Thermographic Profiles of Vessel Sealing Devices on Thyroid Parenchyma. J Surg Res 2011 Mar 29 [Epub ahead of print][WoS]
  • Humes DJ, Ahmed I et al.: The pedicIe effect and direct coupling: delayed thermal injuries to the bile duct after laparoscopic cholecystectomy. Arch Surg 2010 Jan; 145(1): 96-98.
  • Katsuno G, Nagakari K, Fukunaga M et al.: Comparison oftwo different energy-based vascular sealing systems for the hemostasis of various types of arteries: a porcine model-evaluation of LigaSure ForceTriad™. J Laparoendosc Adv Surg Tech A 2010 Nov; 20(9): 747-51.[WoS]
  • Landman J, Kerbl K, Rehman J et al.: Evaluation of a vessel sealing system, bipolar electrosurgery, harmonic scalpel, titanium clips, endoscopic gastrointestinal anastomosis vascular staples and sutures for arterial and venous ligation in a porcine model. J Urol 2003 Feb; 169(2); 697-700.
  • Phillips CK, Hruby GW, Durak E et al.: Tissue response to surgical energy devices. Urology 2008 Apr; 71(4): 744-48.[WoS]
  • Hruby GW, Marruffo FC, Durak E et al.: Evaluation of surgical energy devices for vessel sealing and peripheral energy spread in a porcine model. J Urol 2007 Dec;178(6): 2689-93.
  • Buxbaum E: Fundamentals of Protein structure and Function. Springer, New York 2007.

Document Type

Publication order reference


YADDA identifier

JavaScript is turned off in your web browser. Turn it on to take full advantage of this site, then refresh the page.