Department of Women's Health, Tuebingen University Hospital, Tuebingen, Germany.
Surg Technol Int. 2022 May 19;40:190-196. doi: 10.52198/22.STI.40.GY1544.
Electrosurgery in gynecology has changed over the past few decades. The use of energy-based devices, especially in minimally invasive procedures, is extremely important for preparation, short reconvalescence and patient safety. Recently, there have been major advances in energy-based surgical devices that have further shortened OR time and increased patient safety. Although bipolar and monopolar electrosurgery is still very important, the introduction of high-frequency ultrasound in gynecologic surgery has improved cutting and coagulation by lowering thermal damage in the surrounding tissue. Furthermore, new technical inventions have fundamentally changed the treatment of specific diseases. The introduction of ablation in the therapy of uterine fibroids, for example, has made conventional myomectomy no longer necessary in some cases, as necrosis of fibroids can be induced by placing very small thermal probes into the fibroids. Robotic surgery will change the face of gynecological surgery in the near future, as the initial studies could show lower surgical morbidity and faster recovery of patients after robotic-assisted laparoscopy. In this article we provide a short overview of current technical advances, review possible indications as well as limitations, and take a look into the future of minimally invasive surgery in gynecology.
妇科电外科在过去几十年中发生了变化。能量器械的使用，特别是在微创手术中，对于准备、缩短康复时间和患者安全非常重要。最近，能量外科器械有了重大进展，进一步缩短了手术室时间，提高了患者安全性。尽管双极和单极电外科仍然非常重要，但高频超声在妇科手术中的引入通过降低周围组织的热损伤改善了切割和凝血效果。此外，新的技术发明从根本上改变了特定疾病的治疗方法。例如，在子宫肌瘤的治疗中引入消融技术，在某些情况下已使传统的子宫肌瘤切除术不再必要，因为通过将非常小的热探头放置在肌瘤内可以诱导肌瘤坏死。机器人手术将在不久的将来改变妇科手术的面貌，因为初步研究表明，机器人辅助腹腔镜手术后患者的手术发病率更低，恢复更快。本文简要概述了当前的技术进展，回顾了可能的适应证和局限性，并展望了妇科微创技术的未来。
