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Laparoscopic lymph node dissection using ultrasonically activated shears: comparison with electrosurgery.

Z Holub1, A Jabor, L Kliment

  • 1Department of Obstetrics and Gynecology, Endoscopic Training Center, Baby Friendly Hospital, Kladno, Czech Republic. holubz@seznam.cz

Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
|August 20, 2002
PubMed
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Ultrasonic (US) technique for laparoscopic lymph node dissection (LND) in gynecologic cancer patients yielded more lymph nodes harvested than electrosurgery (ELC). US dissection also improved histology slide readability.

Area of Science:

  • Gynecologic Oncology
  • Surgical Technology
  • Minimally Invasive Surgery

Background:

  • Laparoscopic lymph node dissection (LND) is a key staging procedure for gynecologic cancers.
  • Comparing surgical techniques is crucial for optimizing patient outcomes.

Purpose of the Study:

  • To compare perioperative outcomes of laparoscopic LND using electrosurgery (ELC) versus ultrasonic (US) techniques.
  • To evaluate the efficacy and safety of different energy devices in LND for gynecologic malignancies.

Main Methods:

  • A comparative study of 59 women with cervical or endometrial cancer undergoing laparoscopic LND.
  • Patients were divided into two groups based on the operative technique: ELC or US.
  • Perioperative parameters and lymph node yield were analyzed using the Wilcoxon's rank-sum test.

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Main Results:

  • No significant differences were observed in operation time, blood loss, hospital stay, or complications between ELC and US groups.
  • The US group harvested a significantly higher mean number of lymph nodes (17.5) compared to the ELC group (13.7).
  • Histology slide readability was better after US dissection due to less thermal injury.

Conclusions:

  • Ultrasonic (US) technique is effective for laparoscopic lymph node dissection (LND) in gynecologic cancer.
  • US offers advantages in lymph node yield and improves histological assessment compared to electrosurgery (ELC).