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Ultrasonic shears advocated for node retrieval.(Gynecology)
NEW YORK -- Use of ultrasonic shears for pelvic and paraaortic lymph node retrieval appears to be safe, effective, and potentially advantageous, compared with other modalities, Dr. Jyoti Yadav said at an international congress of the Society of Laparoendoscopic Surgeons.
In contrast to electrosurgery, ultrasonic energy may result in less tissue damage because it allows for dissection and coagulation at lower temperatures. Ultrasonic energy obviates the electrosurgical problems of coupling, grounding, and arcing. Its thermal spread is 0.05 mm versus 0.35 mm with electrosurgery, said Dr. Yadav of Mount Sinai School of Medicine, New York.
Made by several different manufacturers, ultrasonic shears comprise an active and an inactive blade, with a narrow curvilinear tip allowing for both grasping and dissection. The precision of cutting and coagulation is controlled by adjusting the power level (1-5), tissue traction, and blade pressure.
Dr. Yadav reported her institution's experience with a series of 100 patients who underwent transperitoneal laparoscopic pelvic and/or paraaortic lymphadenectomy between January 1999 and April 2004 using ultrasonic shears from different manufacturers (Ethicon Endo-Surgery, Johnson & Johnson, Olympus) as the primary instrument for dissection and hemostasis.
The patients' mean age was 57 years. Their indications for surgery included cancers of the endometrium (48 patients), cervix (29), ovary (15), fallopian tube (2), and vagina (2). Two patients had synchronous endometrial and ovarian cancers, and two had mixed mullerian malignant tumors. Paraaortic lymphadenectomy was done in 30 patients, pelvic lymphadenectomy in 49, and both in 21.
A multipuncture operative technique was used, including a 5-mm or 10-mm umbilical or supraumbilical trocar for introduction of the laparoscope, a 5- to 12-mm suprapubic port for extraction of tissue, two lateral ports in the lower abdomen for ancillary instrumentation, and a fifth trocar in ...
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Source: HighBeam Research, Ultrasonic shears advocated for node retrieval.(Gynecology)