Electrocoaptive closure of linear incisions in the ureter.

High-frequency electric currents were intro-· cluced into medical practice at the close of the last century. The practical irnplications of highfrequency currents were soon noted with the observation that frequencies of more than 10,000 per second produced heat without nrnscular contraction. This fact led to the development of electrocoagulation as a substitute for actual coagulation of blood vessels. Electrocoagulation of blood vessels may be accomplished by either obliterative or coaptive closure. In the obliterative closure the electrode is directly applied to the vessel causing coagulation of the blood vessel and the surrounding tissues. This produces shrinkage of the vessel wall and obliteration of the lumen by coagulated tissue and thrombosis. In the coaptive closure the edges of the vessel are mechanically opposed with a forceps and then sealed coagulation. In 1963 Sigel and Acevedo first described electrocoaptive closure for repair of linear incisions in arteries and veins and the construction of venous anastomoses.1 The application of this technique to blood vessels .suggested that it might also be used in ureteral closure. The usual method for blood vessel and ureteral anastomoses has been a direct suture technique which is both practical and reliable. However, the possibility of compromising the lumen or producing excessive periureteral fibrosis has always been present. This report describes our ,vork in closing ureterotomy incisions eleetrocoaptation. Essentially, the ureteral walls were coapted by a limited, heat-formed coagulum produced by a high-frequency electric current passed through the tissues to be joined. Not much information is available on the exact action of high-frequency electric currents 011 particularly on the ureter. Several questions needed to be answered. 1) Could a.