RESUMEN
Objective:To investigate the feasibility and efficacy of focused ultrasound surgical clamp(FUSC)for partial hepatectomy,and find out the enhancement effect of SonoVue to FUSC.Methods:Twelve healthy goats were randomly divided into a FUSC group(n=6)in which FUSC was only used for the liver ablation,and a SonoVue + FUSC group(n=6)in which FUSC was performed immediately after iv injection of ultrasound contrast agent SonoVue.A FUSC was comprised of two ultrasound transducers fixed on a forceps-like handle.The directions of focused ultrasound beams produced by both transducers were opposite,with the same central axes.Ultrasound energy was continuously delivered by two transducers to ablate liver tissue located between both transducers.The frequency was 1.6 MHz,and the acoustic power was 150 W.All goats in both groups underwent laparotomy,and then the liver was totally exposed for an ablative procedure.Blood loss,FUSC exposure time,operation time required for the hepatectomy and the cross-section area of the resected liver were recorded.Histological changes were observed in the removed liver,and 10ml blood samples were collected in each goat to measure blood cells and hepatic functions after surgical procedure.All goats were followed up for complications and survival.Results:After surgical procedure,all animals survived well,and no complications were observed during follow-up period.Mean blood loss and mean exposure time were(16.9?4.2)ml and(174?9)s in the FUSC group,and(16.3?3.5)ml and(122?9)s in the SonoVue+FUSC group respectively.A statistical difference of average FUSC exposure time per unit area(P0.05)in both groups.Pathological examination showed coagulation necrosis of the targeted liver tissue,and small blood vessels were severely destroyed,with the occlusion of the ablated vessels.There was a transient increase of serum ALT,AST,TB and DB levels postoperatively in all goats,and they reduced to a normal level 7 days after surgical procedure.Conclusion:FUSC is feasible and effective for partial hepatectomy,which has advantage of convenience,less time and blood loss.FUSC combined with microbubble contrast agen(tSonoVue)can enhance the biological effects of FUSC and improve the efficiency of FUSC.
RESUMEN
PURPOSE: To guarantee the proper tension of the tape, we have adopted standardized methods by using Babcock clamp. MATERIALS AND METHODS: Medical records of 118 women who underwent Tension-Free Vaginal Tape Obturator (TVTO) prucedure were retrospectively reviewed. Tension of the tape was controlled either by holding the 1 cm length of the mesh with Babcock clamp in 72 cases (Group I), or by placing Metzenbaum scissor between the tape and the urethra in 46 cases (Group II) before pulling on the tape. The preoperative evaluations included symptom questionnaire, history taking, physical examination, one hour pad test and complete multichannel urodynamic study. Postoperatively, uroflowmetry, postvoiding residual urine volume and symptom questionnaire were repeated. RESULTS: The success rates of the operation were not different between groups. However, postoperative complication rates, including persistent pain and de novo urgency, in the Group II (n=9, 19.6%) was higher than in Group I (n=6, 8.3%). The rate of postoperative transient urinary retention was also higher in Group II (p<0.05). The rate of the patients who answered [satisfied] were significantly high in Group I (95.8%) compared to Group II (80.4%). CONCLUSIONS: By using the Babcock clamp technique, the complications can be minimized, and satisfaction increased. Our findings suggest that this technique does assure the proper tension for the normal voiding postoperatively.