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Objective To compare the clinical therapeutic effect of LigaSure vessel sealing system ,ultrasonic scalpel and mo‐nopolar high frequency electrocautery in open thyroid operation .Methods 293 cases of thyroid operation sequentially admitted in our hospital and in accordance with the inclusion criteria were collected and divided into three groups by the method of random dig ‐its table .There were 98 cases in the LigaSure vessel sealing system group (L‐Sure group) ,100 cases in the ultrasonic scalpel (US group) and 95 cases in the monopolar high frequency electrocautery (M‐E group) .The intraoperative and postoperative conditions were compared among 3 groups .Results The operation time ,intraoperative amount of bleeding and postoperative drainage in the L‐S group and the US group were significantly less than those in the M‐E group (P0 .05) .Conclusion The LigaSure vessel sealing system and ultrasonic scalpel can shorten the operation time ,reduce the amount of bleeding and postoperative drainage ,relieve pain and reduce the hospitalization duration .
ABSTRACT
ObjectiveTo explore the practicability and security of the ultracision harmonic scalpel in radical gastrectomy for patients with proximal gastric cancer.Methods115 patients of stage Ⅰ ～ Ⅲ proximal gastric cancer undergone radical gastrectomy were analyzed retrospectively.65 patients were performed with ultracision harmonic scalpel,the other 50 patients were performed with conventional operation.The operative time,volume of intraoperative hemorrhage,length of incision,and postoperative complications were analyzed.ResultsThere were significant difference in operative time ( 126.9 ± 20.7 ) min and ( 150.6 ± 31.7 ) min ( P ＜ 0.05 ),volume of intraoperative hemorrhage (105.7 ±40.3)ml and (171.7 ±63.2)ml(P＜0.01) and length of incision(17.2 ±2.1)cm and (20.3 ±2.3)cm (P ＜ 0.05 ).There was no significant difference in the postoperative complications between ultracisiou harmonic scalpel group and conventional group.All patients recovered without severe complications.ConclusionRadical resection of proximal gastric cancer using ultracision harmonic scalpel could shorten operative time,decrease intraoperative hemorrhage,shorten incision length,and the technique is convenient and safe.
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Objective To study the application of ultracision harmonic scalpel in laparoscopic radical gastrectomy.Methods Ten patients with gastric cancer were given laparoscopic-assisted radical gastrectomy by using ultracision harmonic scalpel.Results All operations were successfully performed with ultracision harmonic scalpel,and none of which converted into open surgery.The operation time was 300-492 min,mean(385?64) min.The blood loss was 100-500 ml,mean(401?70) ml.The number of harvested lymph nodes was 21-43,mean 31?6.The time for gastrointestinal function recovery was 3-6 d,mean(4.2?1.0) d.The time of patients' taking out-of-bed activity was 3-7 d,mean(4.5?1.3) d.The time of taking liquid food was 4-6 d,mean(5.0?0.9) d.No case had relapse or metastasis after 4-20 months(mean 12.6 months) of follow-up.Conclusions Laparoscopic radical gastrectomy by using ultracision harmonic scalpel is safe and feasible.Ultracision harmonic scalpel has the advantage of minimal invasion,less bleeding and shorter operation time,which is a very important equipment and useful for laparoscopic gastrointestinal surgery.
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Objective To explore the value of Ligasure and Ultracision in total laparoscopic hysterectomy (TLH). Methods From January 2002 to December 2006,totally 225 patients received total laparoscopic hysterectomy in our hospital. Among the cases,Ligasure was used in 152 patients,and Ultracision were employed in 72. The clinical data of the patients were reviewed. Results The mean operation time in the Ligasure group was significantly shorter than that in the Ultracision group [(104.9?29.2) min vs. (152.4?46.6) min,t=-9.329,P=0.000]. And the mean blood loss of the Ligasure group was significantly less than that in the other group [(32.9?14.9) ml vs. (126.4?12.1) ml,t=-46.710,P=0.000]. In both the groups,no patient was converted to open surgery or developed complications or surgical injuries. Conclusions Both Ligasure and Ultracision are safe and effective for total laparoscopic hysterectomy. Ligasure is superior in the management of uterine vessels,while the Ultracision is more effective in opening the vesicle and separating the cardinal ligament.
ABSTRACT
The Harmonic Scalpel made by Ultracision is a system for endoscopic cutting. The energy source is vibration. The power box is attached to a forceps or blade, and the vibrational frequency of the blade approaches 55,500 cycles/second. This causes a knife-like action of the blade through tissue, with enough heating to create coagulation of small vessels. When this vibration energy is applied to the forceps configuration, coagulation occurs. By rotating the bottom blade of the forceps, the instrument becomes like a pair of scissors, and the tissue can divide. The Harmonic Scalpel allows the operator to cut using a tactile tissue. No smoke is created, only microaromized water droplets which are rapidly absorbed by the peritoneak surface. The instrument is extremely safe in that only tissue which is touched is cut; the energy source cannot travel through air, such as can happen with electrosurgery and laser surgery.