McTavish G, Daniell JF, Lalonde C
Centennial Medical Center, 2222 State Street, Suite A, Nashville, TN 37203.
J Am Assoc Gynecol Laparosc. 1994 Aug;1(4, Part 2):S22. doi: 10.1016/s1074-3804(05)80939-9.
Presacral neurectomy is effective treatment for dysmenorrhea and midline pelvic pain. The purpose of this paper is to report the benefits of the argon beam coagulator (ABC) used laparoscopically to perform a presacral neurotomy compared with conventional techniques for presacral neurectomy. In 51 patients undergoing laparoscopic presacral neurectomy, 34 were performed using the ABC only without dissection or excision, and 17 underwent presacral neurectomy by conventional methods. Postoperative pain reduction was the same in both groups, 77% versus 73%, with average anesthesia time 64 minutes for the ABC neurotomy versus 92 minutes with conventional techniques. One major vascular complication requiring immediate laparotomy occurred in the ABC group. When properly applied laparoscopically, the ABC is an effective tool to rapidly coagulate and separate the presacral nerves with minimal smoke, excellent visualization and no retroperitoneal dissection.
骶前神经切除术是治疗痛经和盆腔中线疼痛的有效方法。本文旨在报告与传统骶前神经切除术技术相比，腹腔镜下使用氩离子束凝固器（ABC）进行骶前神经切断术的益处。在51例行腹腔镜骶前神经切除术的患者中，34例仅使用ABC进行操作，无需解剖或切除，17例采用传统方法进行骶前神经切除术。两组术后疼痛减轻情况相同，分别为77%和73%，ABC神经切断术的平均麻醉时间为64分钟，而传统技术为92分钟。ABC组发生1例需要立即剖腹手术的主要血管并发症。在腹腔镜下正确应用时，ABC是一种有效的工具，能够快速凝固并分离骶前神经，烟雾最少，视野极佳，且无需进行腹膜后解剖。
