Skip to main content
PMC home page
Gut logoLink to Gut
. 1984 Dec;25(12):1424–1431. doi: 10.1136/gut.25.12.1424

Which electrode? A comparison of four endoscopic methods of electrocoagulation in experimental bleeding ulcers.

C P Swain, T N Mills, E Shemesh, J M Dark, M R Lewin, J S Clifton, T C Northfield, P B Cotton, P R Salmon
PMCID: PMC1420199  PMID: 6510772

Abstract

Several inexpensive endoscopic methods of electrocoagulation have been advocated for treatment of gastrointestinal haemorrhage. We compared four types of electrode: dry monopolar - Cameron Miller (M), liquid monopolar - Storz (L), bipolar - Bicap ACMI (B), and heater probe - Seattle (H). The electrical and thermal properties of these probes were studied using computerised monitoring of energy deposition and their efficacy and safety was tested in a randomised study in 140 experimental canine gastric ulcers. At optimal pulse settings 20J (M), 70J (L), 17J (B), 15J (H), effective haemostasis was achieved in all ulcers, the mean number of pulses being M5, L6, H6 and B11, the first three requiring significantly (p less than 0.01) less pulse than B. Relative safety of the electrodes was assessed by comparing the incidence of full thickness damage at histology: B24%, H20%, L58% and M69%; B and H proving significantly (p less than 0.01) safer than L and M. Sticking was assessed as H greater than B greater than M much greater than L. Insensitivity to extreme angulation and force of application was assessed as L greater than B greater than M (H is preset). Of the two safer electrodes the heater probe was more effective than the bipolar probe. Despite its greater tendency to stick than the other devices, the heater probe appeared the most promising of the endoscopic electrodes tested.

Full text

PDF
1426

Images in this article

1425Fig. 1
on p.1425
1425Fig. 2
on p.1425

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Blackwood W. D., Silvis S. E. Gastroscopic electrosurgery. Gastroenterology. 1971 Sep;61(3):305–314. [PubMed] [Google Scholar]
  2. Gaisford W. D. Endoscopic electrohemostasis of active upper gastrointestinal bleeding. Am J Surg. 1979 Jan;137(1):47–53. doi: 10.1016/0002-9610(79)90009-6. [DOI] [PubMed] [Google Scholar]
  3. Johnston J. H., Jensen D. M., Mautner W. Comparison of endoscopic electrocoagulation and laser photocoagulation of bleeding canine gastric ulcers. Gastroenterology. 1982 May;82(5 Pt 1):904–910. [PubMed] [Google Scholar]
  4. Mann N. S., Mann S. K. Endoscopic electrocoagulation of superficial bleeding lesions in canine esophagus, stomach and duodenum. Am J Proctol Gastroenterol Colon Rectal Surg. 1978 Sep-Oct;29(5):23-4, 29. [PubMed] [Google Scholar]
  5. Martin L., Peoples J., Protell R., Dennis M., Gilbert D., Rubin C., Silverstein F. The multisection tissue slicer: a simpler technique for assessing the maximal depth of experimental injury. Gastrointest Endosc. 1979 May;25(2):61–62. doi: 10.1016/s0016-5107(79)73362-1. [DOI] [PubMed] [Google Scholar]
  6. Matek W., Frühmorgen P., Kaduk B., Reidenbach H. D., Bodem F., Demling L. The healing process of experimentally produced bleeding lesions after hemostatic electrocoagulation with simultaneous instillation of water. Endoscopy. 1980 Sep;12(5):231–236. doi: 10.1055/s-2007-1021750. [DOI] [PubMed] [Google Scholar]
  7. Papp J. P. Endoscopic electrocoagulation in the management of upper gastrointestinal tract bleeding. Surg Clin North Am. 1982 Oct;62(5):797–806. doi: 10.1016/s0039-6109(16)42829-x. [DOI] [PubMed] [Google Scholar]
  8. Papp J. P. Endoscopic electrocoagulation of actively bleeding arterial upper gastrointestinal lesions. Am J Gastroenterol. 1979 May;71(5):516–521. [PubMed] [Google Scholar]
  9. Papp J. P., Fox J. M., Wilks H. S. Experimental electrocoagulation of dog gastric mucosa. Gastrointest Endosc. 1975 Aug;22(1):27–28. doi: 10.1016/s0016-5107(75)73677-5. [DOI] [PubMed] [Google Scholar]
  10. Pesch H. J., Koch H., Classen M. Experimentelle und histologische Untersuchungen zur Elektrokoagulation blutender Läsionen im oberen Gastrointestinaltrakt. Leber Magen Darm. 1973 Aug;3(4):172–176. [PubMed] [Google Scholar]
  11. Piercey J. R., Auth D. C., Silverstein F. E., Willard H. R., Dennis M. B., Ellefson D. M., Davis D. M., Protell R. L., Rubin C. E. Electrosurgical treatment of experimental bleeding canine gastric ulcers: development and testing of a computer control and a better electrode. Gastroenterology. 1978 Mar;74(3):527–534. [PubMed] [Google Scholar]
  12. Protell R. L., Rubin C. E., Auth D. C., Silverstein F. E., Terou F., Dennis M., Piercey J. R. The heater probe: a new endoscopic method for stopping massive gastrointestinal bleeding. Gastroenterology. 1978 Feb;74(2 Pt 1):257–262. [PubMed] [Google Scholar]
  13. Protell R. L., Silverstein F. E., Piercey J., Dennis M., Sprake W., Rubin C. E. A reproducible animal model of acute bleeding ulcer-the "ulcer maker". Gastroenterology. 1976 Dec;71(6):961–964. [PubMed] [Google Scholar]
  14. Reidenbach H. D., Bodem F., Frühmorgen P., Schroeder G., Lex P., Kaduk B. Eine neue Methode zur endoskopischen Hochfrequenzkoagulation von Schleimhautdefekten. Biomed Tech (Berl) 1978 Apr;23(4):71–74. doi: 10.1515/bmte.1978.23.4.71. [DOI] [PubMed] [Google Scholar]
  15. Silverstein F. E., Protell R. L., Gulacsik C., Auth D. C., Deltenre M., Dennis M., Piercey J., Rubin C. Endoscopic laser treatment. III. Development and testing of a gas-jet-assisted argon laser waveguide in control of bleeding experimental ulcers. Gastroenterology. 1978 Feb;74(2 Pt 1):232–239. [PubMed] [Google Scholar]
  16. Sugawa C., Shier M., Lucas C. E., Walt A. J. Electrocoagulation of bleeding in the upper part of the gastrointestinal tract: a preliminary experimental clinical report. Arch Surg. 1975 Aug;110(8):975–979. doi: 10.1001/archsurg.1975.01360140119023. [DOI] [PubMed] [Google Scholar]
  17. Swain C. P., Bown S. G., Storey D. W., Kirkham J. S., Northfield T. C., Salmon P. R. Controlled trial of argon laser photocoagulation in bleeding peptic ulcers. Lancet. 1981 Dec 12;2(8259):1313–1316. doi: 10.1016/s0140-6736(81)91340-4. [DOI] [PubMed] [Google Scholar]
  18. Swain C. P., Mills T. N., Dark J. M., Lewin M. R., Bown S. G., Northfield T. C., O'Sullivan J. P., Salmon P. R. Comparative study of the safety and efficacy of liquid and dry monopolar electrocoagulation in experimental canine bleeding ulcers using computerized energy monitoring. Gastroenterology. 1984 Jan;86(1):93–103. [PubMed] [Google Scholar]
  19. Taunton J. C. Surgical diathermy - a review. J Med Eng Technol. 1981 Jul;5(4):175–183. doi: 10.3109/03091908109064282. [DOI] [PubMed] [Google Scholar]
  20. Vallon A. G., Cotton P. B., Laurence B. H., Armengol Miro J. R., Salord Oses J. C. Randomised trial of endoscopic argon laser photocoagulation in bleeding peptic ulcers. Gut. 1981 Mar;22(3):228–233. doi: 10.1136/gut.22.3.228. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Volpicelli N. A., McCarthy J. D., Bartlett J. D., Badger W. E. Endoscopic electrocoagulation: an alternative to operative therapy in bleeding peptic ulcer disease. Arch Surg. 1978 Apr;113(4):483–486. doi: 10.1001/archsurg.1978.01370160141024. [DOI] [PubMed] [Google Scholar]
  22. Wara P., Højsgaard A., Amdrup E. Endoscopic electrocoagulation--an alternative to operative hemostasis in active gastroduodenal bleeding? Endoscopy. 1980 Sep;12(5):237–240. doi: 10.1055/s-2007-1021751. [DOI] [PubMed] [Google Scholar]
  23. Youmans C. R., Jr, Patterson M., McDonald D. F., Derrick J. R. Cystoscopic control of gastric hemorrhage. Arch Surg. 1970 Jun;100(6):721–723. [PubMed] [Google Scholar]

Articles from Gut are provided here courtesy of BMJ Publishing Group

RESOURCES