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PICO question

In dogs that undergo intestinal surgery, does the use of monopolar electrosurgery for intestinal incisions increase the risk of dehiscence when compared to a scalpel blade?

Clinical bottom line

Currently there are two experimental in vivo studies comparing electrosurgery with scalpel blade intestinal incisions in dogs, one in cats and one in pigs. In dogs and cats, there is data regarding incisions on the large intestine but not the small intestine.

Colotomy and colectomy performed with monopolar electrosurgery has resulted in significant mortality (up to 60%) during the short-term postoperative period in dogs. Although the studies reviewed have several limitations, the outcome using scalpel blades was significantly better, therefore colonic surgery using electrosurgery is contraindicated. It is likely that small intestinal surgery has the same contraindication but more definite conclusions cannot be made until higher quality evidence is available.

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