Sutton C
Royal Surrey County Hospital, Guildford, UK.
Curr Opin Obstet Gynecol. 1995 Aug;7(4):248-56.
The power sources used in endoscopic surgery are varied and numerous, and will continue to improve as technology progresses. Early attempts at operative laparoscopy were crude, limited by the available instrumentation, and tended to be frustrating: scissors that had to be frequently sharpened and endocoagulators that took a seemingly interminable time to achieve their tissue effect. New developements in ultrasonic energy and different wavelengths of laser energy are used alongside increasingly sophisticated electrosurgical tools, employing both monopolar and bipolar systems, and innovative delivery systems such as the argon beam coagulator and the Helica Thermal Coagulator. All of these systems have their advocates and their detractors, but in the end the choice of power source is determined by the type of equipment that the operator feels most comfortable with. The surgeon must have a detailed knowledge of the physical concepts required to generate the power source, and be able to understand the complications that can be created by the energy, how to avoid them, how and to deal with them if they occur. Although there are subtle differences in the reaction of the different energy sources with human tissue, the clinical outcome appears to be much the same, and depends more on the skill of the individual surgeon than the power source employed.
用于内镜手术的电源种类繁多，且随着技术的进步将不断改进。早期的腹腔镜手术尝试很粗糙，受到可用器械的限制，往往令人沮丧：剪刀需要频繁磨尖，电凝器达到组织效应的时间似乎长得没完没了。超声能量和不同波长激光能量的新发展与日益复杂的电外科工具一起使用，这些工具采用单极和双极系统，以及创新的输送系统，如氩束凝血器和螺旋热凝血器。所有这些系统都有其支持者和反对者，但最终电源的选择取决于操作者感觉最顺手的设备类型。外科医生必须详细了解产生电源所需的物理概念，并能够理解能量可能引发的并发症、如何避免这些并发症，以及如果并发症发生如何处理。尽管不同能量源与人体组织的反应存在细微差异，但临床结果似乎大致相同，更多地取决于个体外科医生的技能而非所使用的电源。
