BLOODLESS SURGERY

Taranaki Daily News, 11 September 1934, Page 10

BLOODLESS SURGERY

VALUE ALREADY PROVED USE AT HAWERA HOSPITAL. ELECTRICAL DEVELOPMENT. It is a fact not generally realised by South Taranaki people that for three or four months past the Hawera public hospital has been the scene of operations conducted with one of the very latest developments in surgical practice, the electric diathermy apparatus. The radio knife, as it is termed colloquially, is really a misnomer, for the operating instrument is merely a loop of wire, a blunt blade of half an inch long of a balltipped pencil-like attachment capable of making incisions or of removing growths, states an article in the Health and Physical Culture magazine.

The first recorded instance of the employment of electrical waves in the treatment of certain diseases is that of William J. Lorton, who read a paper before the Academy of Medicine in New York in 1881. Lorton used an electric current which oscillated in the neighbourhood of 100,000,000 alternations per second. It was claimed that when this current was used the patient experienced only a soft agreable sensation without any twitching of the muscles. The next chapter in the history comes from the laboratory of d’Arsonval at Paris, who was one ef the most enthusiastic of all workers in the employment of electricity in medicine. D’Arsonval demonstrated that highfrequency current of high tension could be passed through living tissues without pain if the alternations were above 10,000 a second. This treatment, too, increased the temperature of the body and improved the breathing. Following this development came others in fairly rapid succession. Dr. F. R. Cook, in 1906 while working with a static electric machine sustained a superficial bum which gave him an idea. He soon developed an electric current with which he successfully destroyed small benign skin tumours such as warts. He went further still after more experimentation and used his current to remove infected tonsils and other minor growths. DE FORREST’S DISCOVERY. It was not until 1908 that de Forrest, the inventor of the radio vacuum tubfe, or valve, discovered that these electric currents could be made to cut. He, with two other scientists, Neill and Sternberg, experimented on dogs and were able to make fine, clean incisions that entailed practically no bleeding. Actually it was de Forrest, who gave the radio knife to the world, but he met with such little encouragement that little more was heard of it till in Germany Drs. Cohen and Stoye constructed, an apparatus which they used with considerable success.

Not until 1923, however, did the radio knife come into favour. Dr. George Wyeth, New York, constructed a more advanced knife and used it extensively in his practice with great success. After the publication of his report upon the work the idea was enthusiastically received for the first time. At last surgeons were able to do what previously they. had only dreamed of doing. The advantages of the radio knife, which is not meant to supersede manual surgery but only to aid it, may be stated briefly. Operations are practically bloodless, except when a large blood vessel has to the cut, because the electricity from the knife seals up the smaller blood vessels as it cuts. There is less likelihood of infection because the heat generated by the high frequency knife kills all bacteria. A very important point is that the knife also kills all animal cells, which is an advantageous factor, particularly when operating for cancer. At the same time all lymph channels are sealed and the cancer cells prevented from entering them. Thus cancerous growths through infection are prevented. The current also blunts the ends of the nerves' cut during the operation and so shock is minimised and post-operation pain practically abolished, thus assuring, the patient of an immediate pleasant convalescence. Another desirable feature is that the wound heals immediately and the scar left is considerably less noticeable than that made by the ordinary surgical instrument. Where the radio knife is perhaps the most successful, however, is in the fact that it renders possible operations upon patients suffering from haemophilia, who bleed profusely and dangerously from the most insignificant wound. Upon these people major operations Were at one time practically impossible and when undertaken subjected the patient to an inordinate amount of danger of bleeding to death. To remove an appendix from patients suffering from haemophilia was a nightmare no surgeon ever wished to face. Even this operation is now relatively safe. i BRAIN SURGERY. The radio knife is the only surgical instrument which can be safely used in brain surgery. Electro-surgery has been responsible for the, successful removal of many brain tumours, which no surgeon would have thought of attempting to remove by the ordinary surgical methods.

One of the jnost obstinate of nerve diseases, known as trifacial neuralgia, has been treated successfully by an American doctor, who has been able to effect deep coagulation of the nerve at one sitting with a permanent cure. With the old surgical method patients have been operated on for this condition as many as six times without permanent relief.

Still another field of surgery in which the radio knife is supreme is that which involves operations on organs rich in blood vessels and which with the ordinary surgical knife suffer considerable loss of blood. Of these organs the most important are the thyroid glands, the kidney, the liver and the spleen. The heavy bleeding caused by operations upon these organs have alarmed many a surgeon by violent and constant gushings calling for as many as 18 to 20 haemostats, or clamps to control bleeding. This fear is abolished with elctrdsurgical diathermy and the surgeon can cut into highly vascular organs with relative impunity.

Perhaps the greatest advance which the apparatus has caused in surgery is that dealing with diseases of the bladder. Tlie diathermy process obviates the necessity for skin wounds, for by the aid of a long tube known as the resectoscope, fitted with tiny electric blub and “telescope”, inserted into the bladder, operations can be performed through the tube with the knife or loop. Bladder obstructions often occur in elderly people, whose reactions to a severe operation of the ordinary type it would be hard to determine. In such cases the surgeon is either unable to operate or does so with no assuredness of success. Bloodless surgery has meant, for people so afflicted, the banishment of almost all danger and a knowledge that at any time growths can be safely/ controlled. It is also possible in some forms of minor operations to employ electrosurgery with the use of only local anaesthesia and generally speaking, from the point of view of the patient, operative surgery is shorn of many of its discomforts and dangers. “Radio” surgery is also playing an important part in the conquest of cancer, for not only has shock effect been greatly reduced but the danger of re-implantation of cancer cells is practically abolished. Such are the ways in which electro-

surgical diathermy represents such an advance in modern surgery and such, in fact, are some of the operations for which the knife is already in use at the Hawera hospital.