Efficacy of endoscopic-assisted transaxillary breast augmentation with ultrasonic scalpel and electroscalpel / 中华医学美学美容杂志

Objective:To evaluate the clinical effects of the dissection of the implant pockets with ultrasonic scalpel or traditional electroscalpel through the axillary approach under endoscopic assistant.Methods:A total of 125 female patients with an average of 32.5 years, ranged from 21 to 44 years, underwent endoscopic-assisted transaxillary breast augmentation in the Department of Plastic Surgery, the Affiliated Friendship Plastic Surgery Hospital of Nanjing Medical University, from January 2019 to December 2020, were analyzed retrospectively. The implant pockets were dissected with ultrasonic scalpel (ultrasonic scalpel group) in 64 patients or with traditional electroscalpel (electroscalpel group) in 61 patients. The operation time, operation speed, postoperative drainage, drainage tube removal time and hospital stay of the two groups were compared and analyzed statistically.Results:Compared with the electroscalpel group, the average operation time of the ultrasonic scalpel group 75(71-90) min was significantly shorter than that of the electroscalpel group 105(80-135) min ( t=4.10, P<0.001), the operation speed (3.27±0.44 ml/min) was faster than that of the electroscalpel group (2.52±0.72 ml/min) ( t=4.71, P<0.001), the postoperative drainage 130.5(98.8-193.3) ml was significantly less than that of the electroscalpel group 281.75(145.5-328.3) ml ( t=2.21, P<0.05), and the drainage tube removal time 3 (3-4) d and hospital stay 3 (3-4) d were remarkablely shorter than that of the electroscalpel group 4 (3-4) d, 5 (4-6) d ( t=3.58; t=4.06, P<0.05). Conclusions:The application of ultrasonic scalpel in endoscopic-assisted transaxillary breast augmentation is safe and reliable. In addtion to improving the surgical efficiency, ultrasonic scalpel can reduce blood loss, shorten the time of hospital stay and reduce complications, which is worthy of further promotion in clinical application.

The design and implementation of power control circuit of ultrasonic scalpel based on DSP / 中国医学装备

Objective:To independently develop a power control system of ultrasonic scalpel so as to reduce the energy consumption and maintain the normal temperature of ultrasonic scalpel.Methods:In this paper, the model of equivalent circuit of ultrasonic transducer nearby syntony was built up, and the hardware control system of ultrasonic scalpel based on digital signal processing (DSP) was designed.Results:Through testing the circuit and work performance of power control system, the series of parameters such as effective value and so on which were produced by this system could adjust frequency of power source in time and attain anticipative functional indicator, and it took the ultrasonic scalpel to work in syntonic situation.Conclusion:The tested indicators of power control system of ultrasonic scalpel based on the kernel design of DSP can attain anticipative requirement, and can take this system to work in syntonic situation.

Comparison of a Hemorrhoidectomy With Ultrasonic Scalpel Versus a Conventional Hemorrhoidectomy

PURPOSE: A variety of instruments, including circular staplers, ultrasonic scalpels, lasers, and bipolar electrothermal devices, are currently used when performing a hemorrhoidectomy. This study compared outcomes between hemorrhoidectomies performed with an ultrasonic scalpel and conventional methods. METHODS: The study was a randomized prospective review of data available between May 2013 and December 2013, involving 50 patients who had undergone a hemorrhoidectomy for grade III or IV internal hemorrhoids. The hemorrhoidal pedicle was coagulated with an ultrasonic device in the ultrasonic scalpel group (n = 25) and sutured with 3-0 vicryl material after excision in the conventional method group (n = 25). RESULTS: The patients' demographics, clinical characteristics, and lengths of hospital stay were similar in both groups. The mean ages of the conventional and the ultrasonic scalpel groups were, respectively, 20.8 ± 1.6 and 22.4 ± 5.0 years (P = 0.240). In comparison with the conventional method group, the ultrasonic scalpel group had a shorter operation time (P < 0.005), less postoperative pain on the visual analogue scale score (for example, P = 0.211 on postoperative day 1), and less postoperative bleeding (P = 0.034). No significant differences in postoperative complications were observed between the 2 groups. CONCLUSION: A hemorrhoidectomy using an ultrasonic scalpel is an effective and safe procedure. The ultrasonic scalpel reduces the operation time, the postoperative blood loss, and the postoperative pain. Long-term follow-up with larger-scale studies is required to evaluate normal activity after a hemorrhoidectomy performed with an ultrasonic scalpel.

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.

Ultrasonic scalpel versus electrocautery in axillary dissection in breast cancer patients / 临床外科杂志

Objective To evaluate the effects of ultrasonic scalpel and traditional electrocautery on postoperative complications in axillary dissection for breast cancer treatment.Methods The clinical data of 92 breast cancer patients with axillary dissection were analyzed retrospectively.The surgical proce-dures were randomly chosen by patients,including 37 cases with ultrasonic scalpel and 55 cases with elec-trocautery.Both groups were compared in operation time,number of harvested lymph nodes,postoperative drainage in 24 h,seroma formation rate,and drain removal time.Results There were no significant differ-ences in operation time[(148.2 ±30.4)min vs(143.5 ±40.8)min],number of harvested lymph nodes (17 nodes vs 16 nodes),and drain removal time[(16.0 ±5.3)d vs(16.7 ±4.4)d]between ultrasonic scalpel group and electrocautery group(P >0.05 ).There were significant differences in postoperative drainage [(118.8 ±65.8)ml vs(159.2 ±71.3)ml]and seroma formation rate(8.1% vs 20%)between ultrasonic scalpel group and electrocautery group(P <0.01).Conclusion For breast cancer,ultrasonic scalpel is similar to electrocautery in axillary dissection,but it can reduce postoperative complications.

Eficacia, seguridad y eficiencia de las nuevas tecnologías en cirugía tiroidea / Effectiveness, safety and efficiency of new technologies in thyroid surgery

Introduction: Surgery of the thyroid gland is the most performed procedure by the endocrine surgeon. In the last years, new techniques have been incorporated in this procedure. Our objective is to analyse the impact of these techniques in our department. Methods: We performed a retrospective and comparative study among three samples of patients submitted for total thyroidectomy. Group I: Sample of 96 patients operated between 2004 and 2007 performing total thyroidectomy. In this period we didn't use ultrasonic scalpel (US) nor intraoperative neuromonitoring (INM). Group II: Sample of 108 patients operated between 2008 and 2010. In this group we used US for hemostasis. Group III: Sample of 82 patients operated between 2011 and 2012. In this group we used both US and INM. The groups are compared: complications, postoperative stay, surgical time and costs per patient. Results: We analysed the following complications: haemorrhage, postoperative hipocalcemia and recurrent nerve palsy. We didn't find significant differences among the samples of patients but there were a less percentage of recurrent palsy in the third group (4.9 percent vs 12.5 and 11.1 percent). We found significant differences when stay, surgical time and costs were analysed. Conclusion: The use of new techniques in thyroid surgery has supposed an improvement not only in the clinic outcomes but in the surgical time.

Objetivo: La cirugía de la glándula tiroides representa el procedimiento más frecuente que realiza el cirujano endocrino. En los últimos años se han ido incorporando nuevas técnicas aplicadas a este procedimiento. El objetivo de nuestro trabajo es analizar el impacto que dichas técnicas han tenido en nuestro servicio. Material y Métodos: Estudio retrospectivo y comparativo entre tres muestras de pacientes a los que se realizó tiroidectomía total. Grupo I: Muestra de 96 pacientes intervenidos entre 2004 y 2007 a los que se realizó tiroidectomía total. En este período no se utilizó bisturí ultrasónico (BU) ni neuromonitorización intraoperatoria (NMI). Grupo II: Muestra de 108 pacientes intervenidos entre 2008 y 2010. En este grupo se realizó hemostasia con BU. Grupo III: Muestra de 82 pacientes intervenidos entre 2011 y 2012. Se utilizó tanto el BU como la NMI. Se comparan los grupos en cuanto a: complicaciones, estancia postoperatoria, tiempo quirúrgico y coste por paciente. Resultados: Las complicaciones analizadas fueron: hemorragia, hipocalcemia postoperatoria y parálisis del nervio laríngeo recurrente. No encontramos diferencias significativas entre los grupos aunque sí hay una menor tasa de parálisis recurrenciales en el tercer período (4,9 por ciento vs 12,5 y 11,1 por ciento). Hemos obtenido diferencias significativas en estancia, tiempo quirúrgico y coste por paciente. Conclusión: La inclusión de las nuevas técnicas en cirugía tiroidea ha supuesto una mejora en los resultados clínicos así como un ahorro de tiempo de quirófano.

Uso del bisturí ultrasónico para la toma de biopsias pulmonares por toracoscopia en pacientes pediátricos con enfermedad pulmonar intersticial / Use of ultrasonic scalpel for pulmonary biopsy by thoracoscopy in pediatric patients with interstitial lung disease

Introducción. El diagnóstico de la enfermedad pulmonar intersticial en la infancia constituye un reto. La biopsia pulmonar a cielo abierto se ha considerado el mejor procedimiento para obtener tejido pulmonar en niños; sin embargo, la biopsia con toracoscopia puede ser igualmente eficaz y menos agresiva. El objetivo de este trabajo fue analizar los resultados del empleo del bisturí ultrasónico con tres trocares de 5 mm (uno para toracoscopio y dos puertos más de trabajo) para la toma de biopsias pulmonares por toracoscopia. Métodos. Se analizó, retrospectivamente, una serie de casos de niños a quienes se les tomaron biopsias pulmonares mediante toracoscopia, utilizando tres puertos de trabajo y el bisturí ultrasónico, durante el periodo comprendido de enero de 2011 a enero de 2012 en un hospital pediátrico de tercer nivel de atención. Resultados. Se registraron cinco pacientes con edades desde uno hasta 13 años. No se presentaron complicaciones durante el transoperatorio o postquirúrgicas en ningún caso. Al revisar los reportes histopatológicos, se encontró suficiente muestra en todos los casos. El sangrado transquirúrgico fue de 4.3 ml en promedio (de 0.5 a 10 ml). El tiempo quirúrgico varió de 2 a 3 horas. Dos casos ameritaron sondas pleurales, las cuales se retiraron a los dos o tres días después del evento quirúrgico, momento en que se dieron de alta del servicio sin complicaciones. Conclusiones. Se corroboró la factibilidad y la seguridad de una técnica para la toma de muestras mediante el uso del bisturí ultrasónico. Esta técnica es fácilmente reproducible en cualquier centro hospitalario que cuente con el recurso para realizar toracoscopias.

Background. Diagnosis of interstitial lung disease (ILD) in children is challenging. Open lung biopsy was long considered to be the best procedure to obtain lung tissue in children. Thoracoscopic biopsy may be equally effective and less aggressive. In this report we analyze the results of the use of ultrasonic scalpel with the placement of three 5-mm trocars (one for thoracoscope and two working ports) for lung biopsy through thoracoscopy. Methods. We present a retrospective case series of children undergoing lung biopsy through thoracoscopy using three working ports and ultrasonic scalpel. The study was carried out from January 2011 to January 2012 in a third-level pediatric hospital. Results. A total of five patients aged 1 to 13 years were included. There were no complications in the five cases analyzed. The sample obtained was sufficient in all cases for histopathological study. During surgery, bleeding was reported on average of 4.3 ml (range: 0.5-10 ml). Operative time ranged from 2 to 3 h. Two cases required chest tube placement. These were removed 2 to 3 days after the surgical event, and patients were discharged without complications. Conclusions. Feasibility is confirmed of a technique for lung biopsy using an ultrasonic scalpel, which is easily reproducible in any hospital with the necessary resources to perform thoracoscopy. In this series there were no complications, bleeding was low and there was opportune placement of transpleural chest tube.

Clinical application of single-site endoscopy in thyroidectomy / 中国基层医药

Objective To assess the clinical feasibility of trans-areola single-site endoscopic thyroidectomy (TASSET) procedure and review the current literature.Methods 12 patients underwent trans-areola single-site endoscopic thyroidectomy procedure were reported,their clinical data were summarized.Results Single-site endoscopic thyroidectomy was successfully performed by an incision bordering the breast areola in corresponding with the lobe harboring the mass.Conclusion Single-site endoscopic thyroidectomy had excellent cosmetic effect and less trauma,and the procedure was safe and applicable.

The clinical application of ultrasonic scalpel in laparoscopic cholecystectomy / 中国基层医药

Objective To investigate the applicetion value of combined ultrasonic scalpel in laparoscopic cholecystectomy(LC).Methods 140 patients with acute and chronic cholecystitis,gallbladder stone patients,received intraoperative ultrasound combined electrosurgical knife,suction devices auxiliary red line LC.The clinical effects were observed.Results 138 cases were completed cholecystectomy.Blood loss ( 8.16 ± 1.85 ) ml,operation time(38.13 ±4.35) min,Postoperative hospital stay(3.25 ± 1.18)d,4 cases of intraoperative rupture of the gallbladder,Hepatobiliary burns in 1 case,2 cases because of dense adhesions around the gallbladder and gallbladder more extensive anatomical triangle unclear laparotomy.Conclusion The rational use of combined high-frequency ultrasonic scalpel knife,suction devices auxiliary red laparoscopic cholecystectomy,surgical conditions that meet medicalrecords,are safe and reliable,quicker recovery can be achieved by minimally invasive medical treatments.

Surgical Repair of Constrictive Pericarditis in Which the Waffle Shape Cutting of the Epicardium Using an Ultrasonic Scalpel Was Effective / 日本心臓血管外科学会雑誌

A 71-year-old woman was admitted with general fatigue and appetite loss. Computed tomography showed hypertrophy of the pericardium surrounding the anterior of the right ventricule (RV). Cardiac catheterization demonstrated a rise of RV end-diastolic pressure and a dip-and-plateau pattern of the pressure curve of RV without any coronary disease. Therefore, we diagnosed heart failure due to constrictive pericarditis and performed pericardectomy using an Ultrasonic Scalpel through a median sternotomy without cardiopulmonary bypass. No improvement of the hemodynamics during the operation was found despite subtotal pericardectomy. Then, we performed the waffle shape cutting of the residual epicardium using an Ultrasonic Scalpel and obtained improvement of the hemodynamics on the operation. We then obtained increased cardiac output and the improved hemodynamics without a dip-and-plateau of the pressure curve of RV. No recurrence of the constrictive pericarditis has been found for two years. Hence, we consider that the waffle shape cutting of the epicardium using an Ultrasonic Scalpel is one of the most useful surgical repairs.

Suprasternal Mini-thyroidectomy / 中国微创外科杂志

Objective To evaluate the feasibility of suprasternal mini-thyroidectomy.Methods A total of 15 patients with nodular goiter underwent suprasternal mini-thyroidectomy(2.5-3.5 cm in incision at length) with ultrasonic scalpel.Results All operations including unilateral partial thyroidectomy(n=4),unilateral subtotal thyroidectomy(n=2) and bilateral subtotal thyroidectomy(n=9)were completed successfully.The mean operation time was 46 minutes(range,30-65 minutes).The intraoperative blood loss was less than 10 ml,except 25 ml in one patient.No complications occurred except superficial Ⅱ degree skin burn in 2 patients.The mean postoperative hospital stay was 1.8 days(range,1-3 days).All the patients were followed up for 8-10 months and no recurrence was found.Conclusions Suprasternal mini-thyroidectomy is feasible and safe with certain cosmetic effects.

Laparoscopic operation using an ultrasonic scalpel for Hischsprung’s disease in infants and children: Report of 20 cases / 中国微创外科杂志

Objective To summarize the value of laparoscopic operation using an ultrasonic scalpel for the radical treatment of Hischsprung’s disease (HD) in infants and children. Methods Laparoscopic operation was performed in 20 infants and children with HD under general anesthesia from February 2003 to January 2006. The CO_2 pressure of pneumoperitoneum was set at 10~12 mm Hg. By way of three abdominal ports, the diseased colon and rectum were mobilized by dissecting the supplying vessels and severing the peritoneal reflection in the pelvic floor. The modified Soave pull-through procedure was employed to incise and mobilize the rectal mucosa at 0.5 cm above the dentate line. The lateral ligament of rectum was severed and the intraabdominal cavity was reached through the peritoneal reflection. The diseased colon was pulled through the anus passing the level of the transition zone for resection. Then coloanal anastomosis was made between the proximal colon and the cutting edge of the anal canal above the dentate line. Results All the procedures were completed smoothly. The operation time was 120~210 min (mean, 132 min). The length of resected colon was 20~55 cm (mean, 35 cm). The intraoperative blood loss was 5~20 ml (mean, 14 ml), with no need of blood transfusion. Enterocolitis happened in 2 cases postoperatively. Follow-up observations in the 20 cases for 3~36 months (mean, 12.5 months) found no complications. The patients had 1~2 times of fecal discharge per day during follow-up. Conclusions Laparoscopic pull-through procedure using an ultrasonic surgical scalpel has advantages of minimal invasion, little hemorrhage, simple performance, quick recovery, and low complication rate.

Application of Ultrasonic Scalpel in Clinical Surgery / 医疗卫生装备

Ultrasonic scalpels,including incision type and aspiration type,are introduced from aspects of the principles,key technologies and clinical application.Uitrasonic scalpel has the advantages of less bleeding,exact incision,,safety,shortened time of operation and less damage to surrounding tissue.Some technology problems of ultrasonic scalpel are also summarized.It is pointed out that ultrasonic scalpel is the tendency and direction of clinical surgery development,which has extensive application prospects.

A study on ultrasonic scalpel in the management of cystic artery and vein during laparoscopic cholecystectomy / 中国微创外科杂志

Objective To study the feasibility of the ultrasonic scalpel in the management of cystic blood vessels during laparoscopic cholecystectomy(LC). Methods Abdominal blood vessels of two dogs were managed by ultrasonic scalpel under the conditions of two step output power,low tension,low holding force and blunt scalpel head.The blood vessels were sealed and arteries and veins of (1～11)mm were cut.On this basis,the technique was applied to the management of cystic vessels during laparoscopic cystic and biliary operation. Results The sealing and cutting effect was good for the blood vessels of less than 9mm 140/150(93 3%).No blood oozing was found at the cutting ends of blood vessels during and after operation.In all 706 cases of laparoscopic gallbladder and biliary duct operations,no bleeding was found at the cutting ends of blood vessels during and after operation. Conclusions Ultrasonic scalpel can be directly used to seal and cut cystic artery during laparoscopic cholecystectomy.