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Application of ultrasonic scalpel in gynecologic operative laparoscopy
1Department of Gynecology, Women's Hospital, Medical School of Zhejiang University, Hangzhou 310006, China. Zuying@mail.hz.zj.cn
Objective:
To investigate the applied value of the ultrasonic scalpel in gynecologic operative laparoscopy.
Methods:
Gynecologic operations were performed using the ultrasonic scalpel under laparoscopy. Operative bleeding and time, perioperative body temperature and hemogram, and tissue damage were observed.
Results:
Forty-two cases of benign gynecologic diseases were treated with the ultrasonic scalpel under laparoscopy. Among them, there were 4 hysterectomies, 9 ovarian cystectomies, 18 salpingotomies, 4 ectopic pregnancies, 3 myomectomies, 3 adhesiolysis and 1 adnexectomy. The amount of operative bleeding, operating time and the tissue injury were related to the type of operation. The minimual operative bleeding amount, operating time, depth of tissue necrosis, tissue injury score and fibrin deposition score were 24.77 +/- 4.71 ml, 23.39 +/- 3.01 min, 0.22 +/- 0.10 mm, 0.98 +/- 0.21 and 0.38 +/- 0.26, respectively. The maximal operative bleeding amount, operating time, depth of tissue necrosis, tissue injury score and fibrin deposition score were 166.7 +/- 47.18 ml, 127.2 +/- 16.99 min, 0.35 +/- 0.20 mm, 1.25 +/- 0.20 and 0.81 +/- 0.29, respectively. The levels of body temperature, white blood cells and hemoglobin before and after the operations were not statistically different (P > 0.05) except for hysterectomy (P < 0.05).
Conclusion:
The ultrasonic scalpel can be safely applied for gynecologic operative laparoscopy and should be used widely.