New technologies in controlling hemorrhage during pelvic surgery

Electrocautery has been used since the early 20^th century. Despite unquestionable benefits in surgery, it is not effective for medium to large size vessels. New technologies have emerged that allow coagulation of vessels up to 7 mm in diameter. A common principle behind the action of these devices is a precise control of tissue temperature during coagulation. With traditional cautery, temperature rises well above 100°C, burning tissue and forming an eshar. New electrocautery instruments maintain tissue temperature below 60°C, causing collagen to melt and the lumen of the vessel to seal. Two leading devices for open and laparoscopic surgery are PlasmaKinetic and LigaSure. TissueLink is a pen style device used mostly to coaguling large bleeding surfaces. All these instruments have shown a significant decrease in blood loss and operating time in controlled studies.