Chappell Michael C, Moe Kris S, Chang Shu-Hong
Division of Orbital and Ophthalmic Plastic Surgery, University of Washington Eye Institute , Seattle, Washington , USA , and.
Orbit. 2014 Aug;33(4):270-5. doi: 10.3109/01676830.2014.904377. Epub 2014 May 15.
The Sonopet Ultrasonic Aspirator is a surgical tool that uses low-frequency ultrasonic vibrations to fragment tissue while simultaneously irrigating and aspirating the surgical field. This technology is becoming more widely used in orbital, lacrimal, neurological, and skull base surgery, but few studies have examined the learning curve associated with adoption of this technology. We present our surgical learning curve, pearls, and pitfalls using the newest generation Sonopet Ultrasonic Aspirator Universal handpiece in endoscopic dacryocystorhinostomy (eDCR) surgery.
Retrospective chart review of consecutive eDCR surgeries performed by a single surgeon adopting the Sonopet Universal handpiece. Data collected include demographic information, indications for surgery, surgical time, intraoperative findings, anatomic and functional results, and complications.
Twenty-six eDCR surgeries in 20 patients were performed from October 2011 - May 2013. Most patients were female (85.7%) with mean age 53.6 years (range 4-84) and mean follow up of 378 days (range 7-761). For routine unilateral and bilateral surgeries, surgery time decreased by 36.4% and 33.9% before reaching a plateau of 67.2 and 80.7 minutes per case, respectively. Mean surgery time for non-sequential unilateral complex cases was 85.1 minutes, which did not vary significantly over the learning curve. We achieved 100% anatomic success and 84.6% functional success.
The Sonopet Ultrasonic Aspirator Universal handpiece can be used safely and effectively for eDCR surgery. A significant learning curve exists for adoption of this technology. Appropriate handpiece tip selection and machine setting adjustments are crucial for successful adoption of this technology and avoidance of complications.
Sonopet超声吸引器是一种手术工具，它利用低频超声振动破碎组织，同时对手术区域进行冲洗和吸引。这项技术在眼眶、泪道、神经和颅底手术中应用越来越广泛，但很少有研究探讨采用该技术的学习曲线。我们展示了在鼻内镜下泪囊鼻腔造口术（eDCR）中使用最新一代Sonopet超声吸引器通用手柄的手术学习曲线、经验和陷阱。
对一名采用Sonopet通用手柄的外科医生连续进行的eDCR手术进行回顾性病历审查。收集的数据包括人口统计学信息、手术指征、手术时间、术中发现、解剖和功能结果以及并发症。
2011年10月至2013年5月，对20例患者进行了26次eDCR手术。大多数患者为女性（85.7%），平均年龄53.6岁（范围4 - 84岁），平均随访378天（范围7 - 761天）。对于常规单侧和双侧手术，手术时间在分别达到每例67.2分钟和80.7分钟的平稳期之前，分别减少了36.4%和33.9%。非连续单侧复杂病例的平均手术时间为85.1分钟，在学习曲线过程中无显著变化。我们实现了100%的解剖学成功和84.6%的功能成功。
Sonopet超声吸引器通用手柄可安全有效地用于eDCR手术。采用该技术存在显著的学习曲线。正确选择手柄尖端和调整机器设置对于成功采用该技术和避免并发症至关重要。
