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Main drawbacks of the available methods for joining soft tissues in surgical operations are noted. It has been established that under certain conditions it is possible to join incisions in different organs and soft tissues by the method based on heating the joint zone by high-frequency current. This method has much in common with the resistance welding method, that is why it is called welding. Multiple experiments made on animals, and later in clinics, confirmed that the application of welding in surgery is feasible and highly promising. More than 2000 patients were operated in the clinics of Kyiv. Surgical operations are mentioned, which are characterized by the efficient application of welding, and which were verified and mastered by Kyiv clinics.
The most important tasks of modern surgery are development and introduction into clinical practice of new methods of joining organs and tissues, simple to perform for surgeon and favourable for the patient. Existing methods of restoring the continuity of tissue using suture materials, stitching devices, adhesive compositions and other means are imperfect.
Laser welding does not provide the required strength for joints. Laser heating with a protein-based “solder”has a certain potential for application in surgical practice, however, a too complicated technology can impede its wide application.
Electric welding to join incisions of live tissues and organs during surgery was applied for the first time by the team of researchers of Paton Electric Welding Institute (EWI) in cooperation with scientists and specialists of the experimental department of the Institute of Surgery and Transplantology.
First a series of experiments were performed on animals with participation of micro surgeons of “Okhmatdyt”Assosiation.
Operation with application of electric welding tools on man (joining a stomach wound) for the first time in the clinical practice was made in the Central Clinical Hospital in June, 2000.
Successful performance of 44 operations enabled the Ministry of Health of Ukraine issuing a certificate of registration of the equipment for welding organs and tissues and allowing its clinical application. This equipment is currently applied in several clinics of the city of Kyiv.
It is found that widely used coagulation equipment is not suitable for welding. Scientists of Paton EWI in cooperation with doctors managed to determine the specific requirements for the welding equipment. In addition it was necessary to find the method of self-adjustment of the system of high-frequency power supply. Adjustment of the control system should be performed automatically, without distracting surgeon from performance of his main functions.
A lot of attention was given to the shape of the working surface of the electrodes and the material for their manufacture. The latter should meet the conditions of long-term usage without overheating.
Application of electric welding in operations on the liver and spleen allows energy concentration in strictly localized regions and with it avoiding damage of the main tubular structures.
Usage of welding technologies allows fastening surgery performance by 20 to 40 min. on average, reducing blood loss by approximately 250 ml, and achieving the cost effectiveness due to reducing the cases of application of expensive equipment.
There is no doubt that the fields of rational application of welding will expand in the future. Welding will simplify the operation and will allow it to be performed with better results and less blood loss.
Exercises
1. Learn the following words and word combinations:
drawback -недолік
soft tissues -м’які тканини
incision -розріз
high-frequency current -високочастотний струм
to exist -існувати
suture -шовний
stitching devices -клейові засоби
to impede -гальмувати
specific requirements -специфічні вимоги
self-adjustment -самонастройка
conditions of a long-term usage -умови тривалого використання
to apply -застосовувати
liver -печінка
spleen -селезінка
main tubular structures -головні трубчасті структури
cost effectiveness -економічний ефект
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