Kathy S, Hajdu Z, Bokor L, Bagi R
Department of General Surgery, Kenézy Teaching Hospital of University Medical School of Debrecen, Hungary.
Acta Chir Hung. 1997;36(1-4):154-5.
The laparoscopic cardiomyotomy with anterior fundoplication (Heller-Dor procedure) is accepted for treatment of esophageal achalasia. The crucial point of the procedure is proper myotomy and avoid perforation of the esophagus. Hook cautery is widely accepted to dissect the oesophageal muscle. We'd like to demonstrate our experiences with a new device--Ultrasonically Activated Harmonic Scalpel-, witch was used at our operation for achalasia to make the cardiomyotomy. Between December 1993 and December 1996, 11 patients with esophageal achalasia underwent laparoscopic Heller's operation with Dor's antireflux procedures. In one patient we applied the Ultrasonically Activated Harmonic Scalpel (HS) to make the cardiomyotomy. The use of HS and results were evaluated. Application of the Harmonic Scalpel is effective for cardiomyotomy. It can be used more safe than electrocoagulation, because it cause less thermic lesion. It's easy to use at laparoscopic way. A perforation of the esophagus didn't occur. There was no intra-, or postoperative complications. After the operation the patient is free of complains. After our first operation, we have found, that Ultrasonically Activated Scalpel can be applied with safe and good results for the cardiomyotomy at laparoscopic operations for esophageal achalasia.
腹腔镜下贲门肌层切开术加前胃底折叠术（Heller-Dor手术）已被认可用于治疗食管贲门失弛缓症。该手术的关键在于恰当的肌层切开并避免食管穿孔。钩形电刀被广泛用于分离食管肌层。我们想展示我们使用一种新设备——超声刀的经验，它在我们治疗贲门失弛缓症的手术中用于进行贲门肌层切开术。1993年12月至1996年12月期间，11例食管贲门失弛缓症患者接受了腹腔镜下Heller手术加Dor抗反流手术。在1例患者中我们应用超声刀进行贲门肌层切开术，并对超声刀的使用及结果进行了评估。超声刀在贲门肌层切开术中有效。它比电凝使用更安全，因为其造成的热损伤更小。以腹腔镜方式使用很容易。未发生食管穿孔。无术中及术后并发症。术后患者无不适主诉。在我们的首例手术之后，我们发现超声刀在腹腔镜下食管贲门失弛缓症手术的贲门肌层切开术中应用安全且效果良好。
