比较使用单极电凝、超声刀和 LigaSure 对人体腹膜产生的侧向热损伤。
Comparison of lateral thermal damage of the human peritoneum using monopolar diathermy, Harmonic scalpel and LigaSure.
机构信息
Department of Surgery, Split University Hospital and Split University School of Medicine, Split, Croatia.
出版信息
Can J Surg. 2012 Oct;55(5):317-21. doi: 10.1503/cjs.000711.
BACKGROUND
New hemostatic technologies are often employed in open and laparoscopic surgery to reduce duration of surgery and complications. Monopolar diathermy, Harmonic scalpel and LigaSure are routinely used in open and laparoscopic surgery for tissue cutting and hemostasis. We compared lateral thermal damage following in vivo application of 3 commonly used instruments.
METHODS
We used monopolar diathermy, Harmonic scalpel and LigaSure to coagulate and divide the peritoneum of patients who underwent median laparotomy. After anesthesia, median supraumbilical laparotomy was performed, and the peritoneum of each patient was coagulated using different devices. Using light microscopy and morphometric imaging analysis, the width of tissue lateral thermal damage was measured from the point of the peritoneal incision.
RESULTS
We included 100 patients in our study. After a peritoneal incision, the mean lateral thermal damage of monopolar diathermy, Harmonic scalpel (output power 3), Harmonic scalpel (output power 5) and LigaSure were 215.79 μm, 90.42 μm, 127.48 μm and 144.18 μm, respectively.
CONCLUSION
The degree of lateral thermal spread varied by instrument type, power setting and application time. LigaSure and Harmonic scalpel were the safest and most efficient methods of tissue coagulation. Monopolar diathermy resulted in the greatest degree of thermal damage in tissues.
背景
新的止血技术经常被应用于开放和腹腔镜手术中，以减少手术时间和并发症。单极电凝、超声刀和 LigaSure 常用于开放和腹腔镜手术中的组织切割和止血。我们比较了 3 种常用器械在体内应用后的侧向热损伤。
方法
我们使用单极电凝、超声刀和 LigaSure 对接受正中剖腹术的患者的腹膜进行凝固和分离。麻醉后，行正中上脐部剖腹术，使用不同的器械对每位患者的腹膜进行凝固。使用光学显微镜和形态计量成像分析，从腹膜切口处测量组织侧向热损伤的宽度。
结果
我们的研究纳入了 100 例患者。腹膜切开后，单极电凝、超声刀（输出功率 3）、超声刀（输出功率 5）和 LigaSure 的平均侧向热损伤分别为 215.79 μm、90.42 μm、127.48 μm和 144.18 μm。
结论
仪器类型、功率设置和应用时间不同，侧向热扩散程度也不同。LigaSure 和超声刀是组织凝固最安全、最有效的方法。单极电凝导致组织热损伤最大。
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