CO₂ Laser와 쌍극전기소작에 의한 혈관응고 및 혈관수복효과에 관한 실험 = CO₂ Laser and Bipolar Electrocautery Effects on Vessel Coagulation and Arterial Repair

다국어 초록 (Multilingual Abstract)

Hemostatic effect is achieved most efficiently by bipolar electrocoagulation in the neurosurgical operation. As far as function is concerned, the laser surgical unit closely resembles the electrosurgical unit.
It has been possible to unite arterial vessel ends in a very fast procedure by means of heat application with the laser or bipolar electrocautery.
The authors studied the difference between the CO₂ laser and bipolar electrocautery effect on coagulation and anastomosis of vessels experimentally. 46 rats weighing 200gm to 250gm, were used in this study. We divided the experimental animals into 4 groups: 1) arterial coagulation with the CO₂ laser, 2) vessel coagulation with the bipolar electrocautery, 3) arterial anastomosis with the CO₂ laser, 4) arterial anastomosis with the bipolar electrocautery. The CO₂ laser was operated at 10 watts(W) to 50W for vessel coagulation, and 2W for arterial anastomosis. The output of bipolar generator Malis type) varied from 10 to 80 dial setting(DS) for vessel coagulation or arterial anastomosis.
The results obtained were as follows:
1) The lower limit of proper arterial coagulation by the CO₂ laser was 20W, 3 seconds(sec) of exposure time with defocused beam.
2) The arteries were properly coagulated with the bipolar coagulator under the DS 30~40, coagulation time 2∼4 sec. Over DS 50, the artery perforated to active bleeding,
3) The veins were coagulated satisfactorily under DS 20∼30 with l∼5sec. of coagulation time.
4) Both temporary cease of blood flow and using blunt bipolar forceps reduced the coagulation time, and the arteries were not perforated over DS 50.
5) Arterial anastomosis was accomplished with 2W, 0.05sec of exposure with 0.2㎜ of focused CO₂ laser beam. With the bipolar coagulator, the arteries could be anastomosed under DS 5∼10, 2∼3sec. of coagulation time.
6) The patency rate after arterial anastomosis was 71 % with the CO₂ laser, and was 22% with the bipolar coagulator.
7) In the histological examination of coagulated arteries, the entire layers of laser irradiated side revealed destruction and constriction. On the contrary the arteries coagulated with bipolar coagulator showed destruction of adventitia and media sparing intima on all around the vessel wall. Anastomosed site revealed coaptation of adventitia and media.