Tsukasa Hotta, Katsunari Takifuji, Shozo Yokoyama, Kenji Matsuda, Takashi Higashiguchi, Toshiji Tominaga, Yoshimasa Oku, Takashi Watanabe, Toru Nasu, Tadamichi Hashimoto, Koichi Tamura, Junji Ieda, Naoyuki Yamamoto, Hiromitsu Iwamoto, Hiroki Yamaue, Second Department of Surgery, Wakayama Medical University, School of Medicine, Wakayama 641-8510, Japan.
World J Gastrointest Surg. 2012 Jan 27;4(1):1-8. doi: 10.4240/wjgs.v4.i1.1.
Laparoscopic surgery for colorectal disease has become widespread as a minimally invasive treatment. This is important because the increasing availability of new devices allows us to perform procedures with a reduced length of surgery and decreased blood loss. We herein report the results of a literature review of energy sources for laparoscopic colorectal surgery, focused especially on 6 studies comparing ultrasonic coagulating shears (UCS) and other instruments. We also describe our laparoscopic dissection techniques using UCS for colorectal cancer. The short-term outcomes of surgeries using UCS and Ligasure for laparoscopic colorectal surgery were superior to conventional electrosurgery. Some authors have reported that the length of surgery or blood loss when Ligasure was used for laparoscopic colorectal surgery is less than when UCS was used. On the other hand, a recent study demonstrated that there were no significant differences between the short-term outcomes of UCS and Ligasure for laparoscopic colorectal surgery. It is therefore suggested that the choice of technique used should be made according to the surgeon's preference. We also describe our laparoscopic dissection techniques using UCS (Harmonic ACE) for colorectal cancer with regard to the retroperitoneum dissection, dissection technique, dissection technique around the feeding artery, and various other dissection techniques. We therefore review the outcomes of using various energy sources for laparoscopic colorectal surgery and describe our laparoscopic dissection techniques with UCS (Harmonic ACE) for colorectal cancer.
腹腔镜结直肠疾病手术已作为一种微创治疗方法得到广泛应用。这一点很重要，因为新设备的不断增加使我们能够以更短的手术时间和更少的出血量来进行手术。本文对腹腔镜结直肠手术的能源进行了文献回顾，重点介绍了 6 项比较超声切割止血系统（UCS）和其他器械的研究。我们还描述了使用 UCS 进行结直肠癌腹腔镜解剖的技术。使用 UCS 和 Ligasure 进行腹腔镜结直肠手术的短期结果优于传统电外科手术。一些作者报告称，在腹腔镜结直肠手术中使用 Ligasure 比使用 UCS 时手术时间或出血量更少。另一方面，最近的一项研究表明，UCS 和 Ligasure 在腹腔镜结直肠手术中的短期结果没有显著差异。因此，建议应根据外科医生的喜好选择技术。我们还描述了使用 UCS（Harmonic ACE）进行结直肠癌腹腔镜解剖的技术，包括腹膜后解剖、解剖技术、供血动脉周围解剖技术以及其他各种解剖技术。因此，我们回顾了腹腔镜结直肠手术中使用各种能源的结果，并描述了我们使用 UCS（Harmonic ACE）进行结直肠癌腹腔镜解剖的技术。
