gms | German Medical Science

88th Annual Meeting of the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery

German Society of Oto-Rhino-Laryngology, Head and Neck Surgery

24.05. - 27.05.2017, Erfurt

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Anesthesia related safety profile of a high-energy ultrasonic scalpel in oropharyngeal and laryngeal surgery: an ex vivo model

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  • corresponding author Nikolay Sapundzhiev - Medical University - Varna, Varna, Bulgaria
  • Georgi Davidov-Georgiev - Medical University - Varna, Varna, Bulgarien
  • Vilian Platikanov - Medical University - Varna, Varna, Bulgaria
  • Chavdar Dimitrov - Medical University - Varna, Varna, Bulgaria
  • Valentin Ignatov - Medical University - Varna, Varna, Varna

Deutsche Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie. 88. Jahresversammlung der Deutschen Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie. Erfurt, 24.-27.05.2017. Düsseldorf: German Medical Science GMS Publishing House; 2017. Doc17hno035

doi: 10.3205/17hno035, urn:nbn:de:0183-17hno0354

Published: April 13, 2017

© 2017 Sapundzhiev et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

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Objective: The aim of this study was to evaluate the fire risks, associated with harmonic scalpel, in a established mechanical model of oropharyngeal/laryngeal surgery.

Methods: A standard PVC endotracheal tube (ETT) was inserted into a degutted, whole raw chicken through which 100% oxygen was piped at 10 L/min. The inflated cuff of the tube was grasped and sectioned with the jaws of a standard high-power ultrasonic dissection system Ultracision (Ethicon). Then the whole ETT was grasped and cut, leaving the device in contact with the ETT for 2 more minutes. In a second step under the same conditions an electrosurgical device was placed into the chicken cavity and activated at the chicken tissue near the ETT at a setting of 20 W. All trials were repeated to ensure accuracy.

Results: No ignition could be produced with the harmonic scalpel under any operation mode settings. In all cases the ETT was cut through by the high-power ultrasonic dissection system with some fumes and brown discoloration at the site of impact. The electrosurgical device easily caused flames within seconds.

Conclusions: Harmonic scalpel appears to be a safer tool than electrosurgical devices in the setting of open cavity surgery in oxygen-enriched environments with respect to the presence of flammable medical PVC devices as ETT or catheters.

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