[HSF] Bayonet Bipolar Forceps

[Nasser F. Abou'Seada]

Bayonet bipolar forceps cautery .... a magnificent tool. Many surgeons don't
use it as it does not "cut" ..... giving them the pleasure of cutting
anything  and fulgurating anything ...... I have seen many surgeons not even
aware of the principal ..... "both Western and Mid Eastern countries" ....
!!
incidentally ... many are not even aware of the "spray" mood ... its
advantages, uses ...etc .... 

NFA
> -----Original Message-----
> From: openheart-l-bounces at lists.hsforum.com [mailto:openheart-l-
> bounces at lists.hsforum.com] On Behalf Of jbflegejr at aol.com
> Sent: Tuesday, November 28, 2006 7:46 PM
> To: OpenHeart-L at lists.hsforum.com
> Subject: Re: [HSF] Deep coronaries with bleeding beds.
> 
> Use bayonet bipolar forceps just like the neurosurgeons. Only the
> tissue beween the tips of the forceps is coagulated; there is virtually
> no spread of current and very little spread of heat as long as low
> intensity current is used. Hold the forceps paralell to the couse of
> the coronary artery, stick one tip into the tissue, muscle or fat,
> pinch and coagulate, then cut the coagulated tissue. I have used this
> many times with high degree of success. It also works well on bleeding
> myocardium; just put the tips of the forceps over the bleeding point,
> not quite closed and coagulate. If blood gets beteen the tips so as to
> conduct current from one tip to the other, a CO2 blower will clear it
> out of the way and and allow for coagulation of the tissue. There is
> very little collateral damage as the current travels from one tip to
> the other. The neurosurgeons use this to control bleeding on the
> surface of the spinal cord and the midbrain without collateral damage.
> It is a mystery to me why so few cardiothoracic and general surgeons
> use the bipolar cautery. For 30 years I never operate without it. John
> Flege
> 
> -----Original Message-----
> From: prasannasimha at gmail.com
> To: OpenHeart-L at lists.hsforum.com
> Sent: Tue, 28 Nov 2006 1:17 PM
> Subject: Re: [HSF] Deep coronaries with bleeding beds.
> 
>     Bipolar over the area of incision ? Attractive though I have one
> concern - even if it is bipolar would there be a possibility of
> coronary injury since at times we may never be sure about the depth of
> the vessel till we actually incise it(especially when dug out of fat -
> muscle - usually we see a mild white streak) ? How often have you used
> this technique and how do you determine the "depth of the burn" ?
>   I think that all the suggestions should be added up into the Wiki. I
> will do this on the week end after I get all the opinions. Prasanna
> 
>  Jbflegejr at aol.com wrote:
>   > The use of bipolar electrocautery on the tissue- muscle or fat-
> before it is > cut is very effective for preventing the kind of
> bleeding that you have > described. John Flege
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