Abstract:

Welding of living tissue began to develop at the Paton Welding Institute (PWI) in the early 90s. The use of welding of living tissues for hemostasis during surgical operations reduces blood oss, the cost and time of the operation. It is available to surgeons with a lower degree of qualification. Bipolar forceps, clamps are used for hemostasis. Monopole electrodes are used for welding and hemostasis in ophthalmology. Instruments with split electrodes are used for bloodless tissue cutting, hemostasis of the surface of wounds and in thoracic surgery. With the help of special clamps with narrow electrodes and modes, bloodless cutting of tissue is possible with simultaneous hemostasis and an increase in the ablasticity of the operation. Hemostasis is carried out due to the formation of a sticky-like biomass, vasospasm and the presence of thrombotic masses. Bioglue is formed, the orientation of endothelial cells changes, collagen and smooth muscle fibers are tightly connected and change at the molecular level. There is practically no thermal damage to the tissue outside the electrodes. The design of the welding tool and the optimal compression force of the electrodes have a great influence on the reliability and strength of hemostasis. With manual setting of welding modes, reliable hemostasis is achieved in 66.4% of cases. An unstable result is observed in 22%, in 11.6% there is no tightness. Using the manual mode setting increases the operation time and fatigue the surgeons. Therefore, it is necessary to use automatic welding control, which eliminates these disadvantages. An examination of the PWI equipment for sealing pigs blood vessels was carried out in the USA. Arteries with a diameter of 2 to 8 mm and aorta were welded. The average strength of the joints is seven times the normal systolic pressure and is equal to 940 +/- 84 mmHg.

Keywords: Living tissue welding, hemostasis, high frequency current, clamp, tweezers