Comparison of Histological Effects of LigaSure and Bipolar Cautery on the Submandibular Gland in a Rat Model

BACKGROUND: Submandibular gland prominence is increasingly recognized as a limiting factor in achieving optimal cervicomental contour. Although energy-based devices are widely used during glandular procedures, their tissue-level effects remain insufficiently defined. OBJECTIVES: To compare the histological impact of a vessel-sealing system and conventional bipolar electrocautery on submandibular gland tissue in an experimental model. METHODS: Twenty-four male Wistar rats were randomly assigned to three groups (LigaSure, bipolar electrocautery, and cold dissection control; n=8 per group). Partial glandular excision was performed under standardized conditions. Tissue specimens were processed for histological analysis using hematoxylin and eosin staining. Edema, hemorrhage, vascular injury, necrosis, inflammation, and ductal narrowing were assessed using a semi-quantitative scoring system. Non-parametric statistical methods were applied for intergroup comparisons. RESULTS: Both energy-based modalities produced significantly greater tissue alterations compared with controls (p<0.05). Bipolar electrocautery demonstrated higher levels of inflammation, edema, hemorrhage, and necrosis relative to LigaSure (p<0.05), while vascular injury showed no statistically significant difference. In contrast, ductal narrowing was significantly more pronounced in the LigaSure group (p<0.05). Overall, the most marked differences between modalities were observed in the inflammatory response and ductal changes. CONCLUSIONS: Distinct patterns of tissue injury are associated with different energy modalities. LigaSure appears to limit collateral tissue damage while exerting a greater effect on ductal structures, whereas bipolar electrocautery is associated with more extensive inflammatory and hemorrhagic changes. These findings provide experimental insight that may inform energy device selection in submandibular gland surgery, although further studies are needed to clarify their clinical implications.

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Publication Details

Journal
Aesthetic Surgery Journal
Published
2026-06-24
DOI
https://doi.org/10.1093/asj/sjag127
Primary Topic
Thyroid and Parathyroid Surgery
Type
article
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article

Comparison of Histological Effects of LigaSure and Bipolar Cautery on the Submandibular Gland in a Rat Model

Selim Zırh, Mine Farımaz, Elham Bahador Zırh, Serhat Şibar et al.
Aesthetic Surgery Journal
Thyroid and Parathyroid Surgery
article

Comparison of Histological Effects of LigaSure and Bipolar Cautery on the Submandibular Gland in a Rat Model

Selim Zırh, Mine Farımaz, Elham Bahador Zırh, Serhat Şibar, Muzaffer Duran, Sami Can Yeşilırmak
article en

Abstract

BACKGROUND: Submandibular gland prominence is increasingly recognized as a limiting factor in achieving optimal cervicomental contour. Although energy-based devices are widely used during glandular procedures, their tissue-level effects remain insufficiently defined. OBJECTIVES: To compare the histological impact of a vessel-sealing system and conventional bipolar electrocautery on submandibular gland tissue in an experimental model. METHODS: Twenty-four male Wistar rats were randomly assigned to three groups (LigaSure, bipolar electrocautery, and cold dissection control; n=8 per group). Partial glandular excision was performed under standardized conditions. Tissue specimens were processed for histological analysis using hematoxylin and eosin staining. Edema, hemorrhage, vascular injury, necrosis, inflammation, and ductal narrowing were assessed using a semi-quantitative scoring system. Non-parametric statistical methods were applied for intergroup comparisons. RESULTS: Both energy-based modalities produced significantly greater tissue alterations compared with controls (p<0.05). Bipolar electrocautery demonstrated higher levels of inflammation, edema, hemorrhage, and necrosis relative to LigaSure (p<0.05), while vascular injury showed no statistically significant difference. In contrast, ductal narrowing was significantly more pronounced in the LigaSure group (p<0.05). Overall, the most marked differences between modalities were observed in the inflammatory response and ductal changes. CONCLUSIONS: Distinct patterns of tissue injury are associated with different energy modalities. LigaSure appears to limit collateral tissue damage while exerting a greater effect on ductal structures, whereas bipolar electrocautery is associated with more extensive inflammatory and hemorrhagic changes. These findings provide experimental insight that may inform energy device selection in submandibular gland surgery, although further studies are needed to clarify their clinical implications.

Aesthetic Surgery Journal
TOBB University of Economics and Technology (TR), Hacettepe University (TR), Gazi University (TR)
Affordable and clean energy
Openalex Percentile: Top 6%
Thyroid and Parathyroid Surgery
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