Dramatic hemostasis of the transected pulmonary artery model using SOFT COAG electrosurgical output.

We report the use of low-voltage, automatically regulated, electrosurgical coagulation to seal the bleeding from pulmonary arteries inadvertently during surgical intervention. Conventional electrosurgical coagulation uses high voltage, which generates intensive heat in the tissue. The heat results in carbonized eschar formation that can be easily broken by mechanical stress and lead to postoperative bleeding. SOFT COAG output automatically regulates the output voltage to a maximum of 200 Volts, preventing the generation of sparking. Thus, there is no formation of carbonized eschar. The instrument generates Joule heat alone in the tissue and the temperature rises to below boiling point, which effectively coagulates protein. Initial experiments, using a beagle model, clearly demonstrated the effectiveness and reliability of sealing both macroscopically and histopathologically. SOFT CAOG can be easily adopted both in open thoracotomy as well as in thoracoscopic procedures.