Shen-Gunther J, Mannel R S, Walker J L, Johnson G A, Sienko A E
Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Nevada School of Medicine, 2040 West Charleston Boulevard, Suite 200, Las Vegas, NV 89102, USA.
J Am Assoc Gynecol Laparosc. 1998 Feb;5(1):47-50. doi: 10.1016/s1074-3804(98)80010-8.
With marked innovations in endosurgical instrumentation, operative laparoscopy to include lymphadenectomy has become feasible and has a valuable role in the management of gynecologic malignancy. We used laparosonic coagulating shears (LCS) for laparoscopic paraaortic lymphadenectomy in two women with cervical carcinoma. Operating times for the laparoscopic portion were 55 and 65 minutes and blood loss was 20 and 30 ml, respectively. No surgical complications were encountered. Lymphatic tissues were evaluated histologically and no thermal artifacts were identified. The major advantage of the ultrasonically activated scalpel of the LCS is the ability to cut and coagulate tissues simultaneously without electrical current. The LCS may afford the surgeon a greater margin of safety than unipolar electrocoagulation scissors by eliminating potential thermal and electrical injury to vital structures. Ultrasonic-activated technology deserves extended clinical investigation in laparoscopic lymphadenectomy to substantiate our preliminary findings, as well as to explore its potential in gynecologic oncology.
随着内镜手术器械的显著创新，包括淋巴结清扫术在内的腹腔镜手术已变得可行，并且在妇科恶性肿瘤的治疗中发挥着重要作用。我们使用腹腔镜超声凝血剪（LCS）为两名宫颈癌女性患者进行腹腔镜主动脉旁淋巴结清扫术。腹腔镜部分的手术时间分别为55分钟和65分钟，失血量分别为20毫升和30毫升。未出现手术并发症。对淋巴组织进行了组织学评估，未发现热伪像。LCS的超声激活手术刀的主要优点是能够在无电流的情况下同时切割和凝固组织。与单极电凝剪刀相比，LCS通过消除对重要结构的潜在热损伤和电损伤，可为外科医生提供更大的安全 margin。超声激活技术值得在腹腔镜淋巴结清扫术中进行进一步的临床研究，以证实我们的初步发现，并探索其在妇科肿瘤学中的潜力。
