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用于犬腹腔镜卵巢切除术的无绳超声解剖器与先进双极血管闭合装置的比较

Cordless ultrasonic dissector versus advanced bipolar vessel sealing device for laparoscopic ovariectomy in dogs.

作者信息

Spillebeen Anneleen L, Janssens Sara S D S, Thomas Rachel E, Kirpensteijn Jolle, van Nimwegen Sebastiaan A

机构信息

Department of Clinical Sciences of Companion Animals, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands.

出版信息

Vet Surg. 2017 May;46(4):467-477. doi: 10.1111/vsu.12640. Epub 2017 Mar 17.

Abstract

OBJECTIVE

To compare Sonicision cordless ultrasonic dissector (SCUD) to LigaSure vessel sealing device (LVSD) for laparoscopic ovariectomy (Lap OVE) in dogs.

STUDY DESIGN

Randomized, paired prospective clinical trial.

ANIMALS

Client-owned dogs (n = 22) presented for elective Lap OVE.

METHODS

Dogs were randomly assigned to one of two protocols: protocol 1 required the left ovary resected using SCUD and the right ovary using LVSD; protocol 2 required the left ovary resected using LVSD and the right ovary using SCUD. Duration of ovary excision, complications, surgical smoke production, and collateral thermal damage were compared between SCUD and LVSD. Total surgery duration, postoperative convalescence, obesity, mesovarial fat score, and technique-associated costs were also recorded.

RESULTS

Ovary excision was significantly faster with LVSD than SCUD. Surgical smoke production was significantly greater for SCUD than LVSD. Minor pedicle hemorrhage occurred 3 times with SCUD and one time with LVSD (not significantly different) and was easily corrected intraoperative. Presence of hemorrhage significantly increased ovary excision time. Technique-associated costs were lower for SCUD than LVSD. No significant differences were found in collateral thermal damage between SCUD and LVSD. Total surgery duration and convalescence time were similar to previous reports of Lap OVE in dogs at the authors' institution.

CONCLUSIONS

SCUD is a cost-effective alternative for Lap OVE, taking into account differences in technique and user preference.

摘要

目的

比较索诺声无绳超声解剖器(SCUD)与结扎速血管闭合装置(LVSD)在犬腹腔镜卵巢切除术(Lap OVE)中的应用效果。

研究设计

随机、配对前瞻性临床试验。

动物

因择期Lap OVE就诊的客户拥有的犬(n = 22)。

方法

将犬随机分为两种方案之一:方案1要求使用SCUD切除左侧卵巢,使用LVSD切除右侧卵巢;方案2要求使用LVSD切除左侧卵巢,使用SCUD切除右侧卵巢。比较SCUD和LVSD在卵巢切除时间、并发症、手术烟雾产生及侧方热损伤方面的差异。还记录了总手术时间、术后恢复情况、肥胖程度、卵巢系膜脂肪评分及技术相关成本。

结果

LVSD的卵巢切除速度明显快于SCUD。SCUD产生的手术烟雾明显多于LVSD。SCUD发生轻微蒂部出血3次,LVSD发生1次(无显著差异),术中均易于纠正。出血的存在显著增加了卵巢切除时间。SCUD的技术相关成本低于LVSD。SCUD和LVSD在侧方热损伤方面无显著差异。总手术时间和恢复时间与作者所在机构之前关于犬Lap OVE的报道相似。

结论

考虑到技术差异和用户偏好,SCUD是Lap OVE的一种经济有效的替代方案。

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