Laparoscopic cystectomy in treating women with endometrioma and pregnancy outcome – a case series

@#Introduction: The aim of this study was to determine the spontaneous pregnancy rate and safety of our surgical technique of performing laparoscopy cystectomy for endometrioma

Application effects observation of ultrasonic scalpel combined with bipolar coagulation tweezers on open thy-roid surgery / 中国基层医药

Objective To investigate the application effects of ultrasonic scalpel combined with bipolar coag-ulation tweezers on open thyroid surgery.Methods 80 cases of thyroidectomy patients were randomly selected.These patients were divided into two groups by random cluster sampling method,whch were the study group (n =40)and control group (n =40).The control group of patients were given ultracision ligature methods combined with traditional therapy,while the study group of patients were given ultrasonic scalpel combined with bipolar coagulation tweezers treatment.And then the surgical related indicators and complications of the two groups of patients were statistically an-alyzed.Results Compared with the control group of (90.5 ±3.6)min,(6.5 ±0.6)d,(40.5 ±2.0)mL,(50.3 ± 1.4)mL and (6.6 ±0.5)cm,the operative time and length of stay of the study group of patients[(58.5 ±5.4)min and (3.4 ±0.2)d]were significantly shorter (t =6.965,3.143,all P <0.05);the blood loss and postoperative drainage of (5.0 ±1.4)mL and (1.0 ±0.6)mL were significantly less (t =4.541,3.747,all P <0.05);the cut diameter of (3.8 ±0.3)cm was significantly shorter (t =3.365,P <0.05);the complication rate of 2.5% (1 /40) was significantly lower than the control group 10.0%(4 /40)(χ2 =9.35,P <0.05).Conclusion The application effects of ultrasonic scalpel combined with bipolar coagulation tweezers on open thyroid surgery are obvious.

Effects of Different Hemostatic Methods in Laparoscopic Ovarian Cyst Resection on Ovarian Functions / 中国微创外科杂志

Objective To investigate the effects of different hemostatic methods in laparoscopic ovarian cystectomy on ovary functions . Methods A total of 90 cases of laparoscopic ovarian cyst resection from June 2010 to June 2013 were selected .They were divided into bipolar electrocoagulation group , monopolar electrocoagulation group , and suture group according to the doctor ’ s favor.The FSH, LH, and E2 before and after surgery were compared among the three groups . Results All patients were followed up for more than 1 year.The rate of patients with menstrual disorder in monopolar electrocoagulation group [33.3%(10/30)] was significantly higher than that in bipolar coagulation group [10.0%(3/30),χ2 =4.812,P=0.028] and suture group [6.7%(2/30),χ2 =6.667,P=0.010].There was no significant difference between bipolar premature coagulation group and suture group (χ2 =0.000, P=1.000).There was no significant difference in FSH ,LH,and E2 among the three groups before and 1 month after surgery (P>0.05).There was no significant difference in FSH ,LH, E2 between bipolar premature coagulation group and suture group 6 months after surgery (P>0.05).In the monopolar electrocoagulation group , the FSH [(10.43 ±2.04) U/L] and LH [(18.58 ± 3.82) U/L] levels were significantly higher than those in the bipolar electrocoagulation group [(8.12 ±1.82) U/L and (13.31 ± 2.53) U/L, P<0.05], and in the suture group [(7.08 ±1.68) U/L and (12.61 ±2.68) U/L, P<0.05].The E2 level in the monopolar electrocoagulation group [(252.5 ±26.9) pmol/L] was significantly lower than that in the bipolar electrocoagulation group [(321.3 ±28.2) pmol/L, P<0.05] and in the suture group [(313.7 ±31.4) pmol/L, P<0.05]. Conclusion In laparoscopic ovarian cystectomy , bipolar coagulation hemostasis is safer than monopolar electrocoagulation hemostasis , being worthy of clinical application .

Histopathological Changes of the Renal Arterial Wall After Bipolar Coagulation in Experimental Rat Models

The bipolar coagulator has been frequently used in reducing the size of aneurismal neck or dissecting the aneurismal sac. However the effects of bipolar current on the wall of vessels have not been adequately documented. The author studied the histopathological changes of the renal arterial wall after bipolar coagulation. Thirty one Sprague-Dawley strain rats of both sexes and of various age were used. Under penthobarbital anesthesia, the left renal artery was coagulated with bipolar forcep just distal to it's origin from the aorta. The rats were divided into two groups:Group A was coagulated for two seconds:Group B for one second. The coagulation sites of vessels were examined grossly and microscopically in three and six months, respectively. The results were summarized as followings: 1) In both three and six months groups:the internal elastic membrane and elastic fibers were destructed, fragmented and thinned;the medial smooth muscle cells were damaged and decreased in number. 2) While the endothelial cells were severely desquamated and scattered in three months group, but there was an evidence of partial regeneration of endothelium and reduction of inflammatory reaction in six months group. Fibrosis was more augmented in six month group than three month group. 3) Between group A and B, There weemed to be no definite discrepancy in histopathological findings. 4) Pseudoaneurysms were developed in 72.2% of three months group and in 61.5% of six months group, but there was no significant statistical difference in the rate of pseudoaneurysm formation between the two groups(p>0.05, chi2=0.393). 5) Above findings suggest that the pseudoaneurysm which might be produced by bipolar coagulation of vessels in the neurosurgical operation, would be progressed to the true aneurysm if continuous hemodynamic factors are exerted upon the pseudoaneurysm. Therefore, it is desirable that the bipolar current should be used very catiously during the surgery of cerebrovascular disease.

The Effect of Monopolar and Bipolar Electrocoagulation in Brain

The monopolar and bipolar coagulation lesions were generated in the cerebral cortex of rabbits. Microscopic study, and the distance from cortical lesion center to its margin, the lesion depth, the extent of lesion in coronal section, and the area of coronal section at electrocoagulation in generation of brain lesion were studied by Evans blue and hematoxylin-eosin stain. The results were as follows : 1) Microscopically, the lesions were characterized by ground substance depigmentation, vacuolization and neuronal damage with pyknotic nuclei and loss of detail. In section stained with Evans blue, the lesion was demarcated with blue-green discoloration of the parenchyma and superfical cortical necrosis was coagulation sites. 2) The distance from cortical lesion center to its margin was proportionally increased as the increase of magnitude of electric current for monopolar and bipolar coagulation, while the distance was independent of the mode coagulation and stain. 3) The depth of lesion was proportionally increased as the increase of magnitude of electric current for monopolar and bipolar coagulation, while the distance was independent of the mode coagulation and stain. 4) The extent of lesion in coronal section was increased the increase of magnitude of electric current for both coagulation modes, while the extent was independent of the mode of coagulation and stain, too. 5) The area of coronal section at cortical lesion center was gradually increased as the increase of magnitude of electric current for both coagulation modes, while the area of Evans blue stain was 2 times as H-E stain in monopolar mode and the area of Evans blue stain was 1.3 times as H-E stain in bipolar mode.

The Effect of Monopolar and Bipolar Electrocoagulation in Spinal Cord

The monopolar and bipolar coagulation lesions were generated in the spinal cord of rabbits. Microscopic study, and the distance from surface lesion center to its margin, the lesion depth, the extent of lesion in cross section, and the area of cross section through the lesion center of monopolar and bipolar electrocoagulation in generation of spinal cord lesion were studied by Evans blue and hematoxylin-eosin stain. The results were as follows : 1) Microscopically, the lesions were characterized by ground substance depigmentation, vacuolization and neuronal damage with pyknotic and angulated nuclei and loss of detail. In section stained with Evans blue, the lesion was demarcated with blue-green discoloration of the parenchyma and superficial necrosis was at coagulation sites. 2) The distance from surface lesion center to its margin was proportionally increased as the increase of magnitude of electric current for monopolar and bipolar coagulation, while the distance was independent of the mode coagulation and stain. 3) The depth of lesion was proportionally increased as the increase of magnitude of electric current for monopolar and bipolar coagulation, while the depth was also independent of the mode coagulation, but the depth of Evans blue stain was 2 times than H-E stain. 4) The extent of lesion in cross section was increased as the increase of magnitude of electric current for both coagulation modes, while the extent was independent of the mode of coagulation and stain, too. 5) The area of cross section through the lesion center was gradually increased as the increase of magnitude of electric current for both coagulation modes, while the area was independent of the mode of coagulation and stain.