Ultrasonic scalpel in laparoscopic Gynecological surgery; an observational Study in 354 cases

Author(s): Jansen FW, Trimbos-Kemper T, Trimbos JB

Abstract

Objective To evaluate the ultrasonically activated scalpel (UAS) and laparoscopic coagulating shears (LCS) for gynaecological laparoscopic procedures. Main outcome measures Data were evaluated regarding type of procedure, duration of surgery, blood loss, complications and cost-effectiveness of the technique. Design Prospective observational study. Setting All patients who underwent a laparoscopic procedure in which the UAS or LCS was used, between 1993 and 2001 at the Leiden University Medical Center. Results A total of 354 consecutive women underwent a laparoscopic procedure with the UAS or LCS. One major complication occurred (bleeding) for which a laparotomy was necessary. The results showed that these instruments are effective tools for cutting and coagulating. Conclusions Additionally to bipolar electrosurgery, the UAS is a safe instrument and is especially useful for extirpative laparoscopic procedures in gynaecology. Due to the cavitational effect, it is not, in our opinion, a good instrument for delicate reconstructive surgery for fertility.

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