ABSTRACT
Energy-based surgical instrumentation (ESI) are surgical devices ablating or cutting tissues via the application of electrical,luminous,acoustic or other energy.High frequency electrotomes are widely used due to the low price,but they produce smoke in the process of surgery and incisions heal slowly.Ultrasonically activated scalpels' cutting performance is satisfying with easily healing incisions while its coagulating capability is poor.Laser scalpels are qualified for both cutting and coagulating in spite of the need of novel technology to overcome the characteristic that tissues absorb laser wavelength selectively.
ABSTRACT
ObjectiveTo discuss the clinical value of ultrasonically activated scalpel(UAS) in breast cancer patients who underwent 2-3 cycles of neo-adjuvant chemotherapy by comparing UAS and electric knives (EI) in modified radical mastectomy. MethodsFrom Jun.2009 to Aug.2011, 52 breast cancer patients taking 2-3 cycles of neo-adjuvant chemotherapy underwent modified radical mastectomy in our hospital. Among them, UAS group included 23 patients, and EI group included 29 patients.The 2 groups were compared in terms of the operation time, intraoperative blood loss, postoperative drainage tube duration, postoperative hospital stay, the number of lymph nodes retrieved, and the volume of subcutaneous hydrops.ResultsBetween the 2 groups, the difference of intraoperative blood loss and postoperative drainage tube duration had statistical significance(P ＜0.01 ).The difference of operation time, hospital stay, and subcutaneous hydrops had statistical significance ( P ＜ 0.05 ).The difference of the number of lymph nodes retrieved had no statistical significance ( P ＞ 0.05 ).ConclusionThere are good curative effects for breast cancer patients undergoing modified radical mastectomy by UAS and axillary lymph node dissection after neo-adjuvant chemotherapy, which is consistent with the conception of fast track surgery.
ABSTRACT
Objective To study the application of ultrasonically activated scalpel in laparoscopic intestinal adhesion release.Methods Intestinal adhesion release with ultrasonically activated scalpel under laparoscope was performed in 29 patients suffered from intestinal adhesive obstruction after gynecological operation. Results All operations were successfully performed, and none of them converted into open surgery. Intestinal disruption occurred durring operation in 2 patients with extensive intestinal denseadhesion which were mended successfully under laparoscope. The operative duration was 30-150 min (mean 45 min). Postoperative complications such as bowel leak age, bleeding, abdominal infection were not experienced. Postoperative hospital stay was 3-7 days (mean 4 days). No case had relapse symptom such as abdominal distention or pain after 1-24 months of follow up. Conclusion Compared with electric scalpel, ultrasonically activated scalpel can improve the operative safety, lessen tissue damage, shorten operative time, and reduce the chance of relapse in laparoscopic operation in gynecology.