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dc.contributor.authorMartinsen, Tormod
dc.contributor.authorPettersen, Fred-Johan
dc.contributor.authorKalvøy, Håvard
dc.contributor.authorTronstad, Christian
dc.contributor.authorKvarstein, Gunnvald
dc.contributor.authorBakken, André
dc.contributor.authorHøgetveit, Jan Olav
dc.contributor.authorMartinsen, Ørjan Grøttem
dc.contributor.authorGrimnes, Sverre
dc.contributor.authorFrich, Lars Inge
dc.date.accessioned2020-02-25T09:47:32Z
dc.date.available2020-02-25T09:47:32Z
dc.date.issued2019-03-12
dc.description.abstract<i>Importance</i>: During monopolar electrosurgery in patients, current paths can be influenced by metal implants, which can cause unintentional tissue heating in proximity to implants. Guidelines concerning electrosurgery and active implants such as pacemakers or implantable cardioverter defibrillators have been published, but most describe interference between electrosurgery and the active implant rather than the risk of unintended tissue heating. Tissue heating in proximity to implants during electrosurgery may cause an increased risk of patient injury.<p> <p><i>Objective</i>: To determine the temperature of tissue close to metal implants during electrosurgery in an <i>in-vitro</i> model.<p> <p><i>Design, Setting, and Participants</i>: Thirty tissue samples (15 with a metal implant placed in center, 15 controls without implant) were placed in an <i>in vitro</i> measurement chamber. Electrosurgery was applied at 5–60 W with the active electrode at three defined distances from the implant while temperatures at four defined distances from the implant were measured using fiber-optic sensors.<p> <p><i>Main Outcomes and Measures</i>: Tissue temperature increase at the four tissue sites was determined for all power levels and each of the electrode-to-implant distances. Based on a linear mixed effects model analysis, the primary outcomes were the difference in temperature increase between implant and control tissue, and the estimated temperature increase per watt per minute.<p> <p><i>Results</i>: Tissues with an implant had higher temperature increases than controls at all power levels after 1 min of applied electrosurgery (mean difference of 0.16°C at 5 W, 0.50°C at 15 W, 1.11°C at 30 W, and 2.22°C at 60 W, all with p < 0.001). Temperature increase close to the implant was estimated to be 0.088°C/W/min (95% CI: 0.078–0.099°C/W/min; p < 0.001). Temperature could increase to above 43°C after 1 min of 60 W. Active electrode position had no significant effect on temperature increases for tissues with implant (p = 0.6).<p> <p><i>Conclusions and Relevance</i>: The temperature of tissue close to a metal implant increases with passing electrosurgery current. There is a significant risk of high tissue temperature when long activation times or high power levels are used.en_US
dc.identifier.citationMartinsen T, Pettersen F, Kalvøy H, Tronstad C, Kvarstein G, Bakken A, Høgetveit JO, Martinsen ØG, Grimnes S, Frich LI. Electrosurgery and temperature increase in tissue with a passive metal implant. Frontiers in surgery. 2019;6:8:1-8en_US
dc.identifier.cristinIDFRIDAID 1747706
dc.identifier.doi10.3389/fsurg.2019.00008
dc.identifier.issn2296-875X
dc.identifier.urihttps://hdl.handle.net/10037/17485
dc.language.isoengen_US
dc.publisherFrontiers Mediaen_US
dc.relation.journalFrontiers in surgery
dc.rights.accessRightsopenAccessen_US
dc.rights.holderCopyright 2019 The Author(s)en_US
dc.subjectVDP::Medical disciplines: 700en_US
dc.subjectVDP::Medisinske Fag: 700en_US
dc.titleElectrosurgery and temperature increase in tissue with a passive metal implanten_US
dc.type.versionpublishedVersionen_US
dc.typeJournal articleen_US
dc.typeTidsskriftartikkelen_US
dc.typePeer revieweden_US


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