Seo Hyunkyoung, Lee Seon-Mi, Seol Aeran, Kim Seongmin, Lee Sanghoon, Song Jae-Yun
Department of Obstetrics and Gynecology, Korea University College of Medicine, 73 Inchon-ro, Seongbuk-gu, Seoul 02841, Republic of Korea.
Medicina (Kaunas). 2024 Dec 2;60(12):1978. doi: 10.3390/medicina60121978.
: The objective of this study was to assess the efficient use of advanced energy devices by examining the impact of their usage frequency on surgical outcomes of total laparoscopic hysterectomies. : A retrospective study was conducted between 2020 and 2023 by a single surgeon. The patients' medical records and surgical videos were reviewed. Cases were categorized into three groups based on the frequency of usage of advanced energy devices: Group 1 (≤10 uses), Group 2 (11-20 uses), and Group 3 (≥21 uses). The differences in blood loss, surgery time, and surgical outcomes among these groups were analyzed. This study was conducted as a single-center retrospective analysis. It included 126 patients who underwent total laparoscopic hysterectomy and provided informed consent for video recording. To evaluate the usage of advanced energy devices, anonymized surgical videos were reviewed, and outcomes were analyzed based on the frequency of usage of advanced energy devices. : The time required for surgery differed significantly among the three groups ( = 0.006). However, no significant differences were observed in the changes in hemoglobin levels or estimated blood loss ( = 0.255 and 0.053, respectively). Additionally, the application of hemostatic agents, the need for intraoperative or postoperative transfusions, and the use of intravenous hemostatic agents postoperatively showed no notable variation. Complication rates, including rates of hematoma, urinary tract injury, gastrointestinal injury, and infections necessitating reoperation, were also comparable. : The findings suggest that the prudent and strategic use of advanced energy devices, rather than their frequent application, may improve surgical efficiency without increasing the risk of complications.
本研究的目的是通过检查先进能量设备的使用频率对全腹腔镜子宫切除术手术结果的影响，来评估其有效利用情况。
一位外科医生在2020年至2023年期间进行了一项回顾性研究。对患者的病历和手术视频进行了审查。根据先进能量设备的使用频率将病例分为三组：第1组（≤10次使用）、第2组（11 - 20次使用）和第3组（≥21次使用）。分析了这些组之间在失血量、手术时间和手术结果方面的差异。本研究作为单中心回顾性分析进行。它包括126例行全腹腔镜子宫切除术并为视频记录提供知情同意的患者。为了评估先进能量设备的使用情况，对匿名手术视频进行了审查，并根据先进能量设备的使用频率分析了结果。
三组之间的手术所需时间存在显著差异（P = 0.006）。然而，在血红蛋白水平变化或估计失血量方面未观察到显著差异（分别为P = 0.255和0.053）。此外，止血剂的应用、术中或术后输血的需求以及术后静脉止血剂的使用均未显示出明显差异。包括血肿、尿路损伤、胃肠道损伤和需要再次手术的感染率在内的并发症发生率也相当。
研究结果表明，谨慎且策略性地使用先进能量设备，而非频繁使用，可能在不增加并发症风险的情况下提高手术效率。
