Comparison between resection, bipolar coagulation and Plasmajet®: A preliminary animal study.

OBJECTIVE(S): To compare the most used types of surgical techniques, for peritoneal lesions management, to Plasmajet® (PJ), in term of healing and post-operative adhesion.

STUDY DESIGN: Prospective, experimental animal study. Female pigs (Landrace/Large White-Pietran) weighing 20-25kgs were used for the experiments. Eleven areas of 2cm2 were treated on each lateral side of the peritoneal wall. Two areas of control, 2 of surgical resection with scissors, 2 of bipolar coagulation, 2 of Plasmajet® 10 low (PJ10L, adjustment of the Plasmajet®) used in contact with the peritoneum, 2 of PJ10L used at 3-5mm from the peritoneum, 2 of PJ10L used at 10mm, 2 of PJ used at 10 High (PJ10H) close to the peritoneum, 2 of PJ10H used at 3-5mm, 2 of PJ10H used at 10mm, 2 of PJ used at 40 Low (PJ40L) used at 3-5mm, 2 of PJ40L used at 10mm from the peritoneum.

RESULTS: For each 2 areas, one was removed immediately for histological analysis. All animals were reoperated 14days later to evaluate macroscopic healing, adhesion score, histological inflammation and mesothelialization. Immediate histological analysis shows that in every treated area the peritoneum was completely vaporized, coagulated or removed. After resection, the healing was macroscopically perfect and there was no adhesion, as in the control area. After bipolar coagulation in half of cases there was adhesion. There was no adhesion after treatment by Plasmajet® 10 low used at 10mm from the peritoneum.

CONCLUSION: Surgical resection leads to perfect healing, and no adhesion formation. The use of Plasmajet® 10 low used at 10mm from the peritoneum could be an alternative to resection, because it allows complete superficial destruction, with a low rate of adhesion. Further study is required to explore and assess fully the potential of this device.