バイポーラー組織シーリングシステム、超音波凝固切開装置を用いたTLHにおける上部靭帯、基靭帯処理の比較

抄録

Objective: The advanced energy devices (AED) bipolar-tissue sealing system (BTSS) and ultrasonic device can be used during total laparoscopic hysterectomy (TLH). When we resect the upper ligaments (the fallopian tube and utero-ovarian ligaments) and the cardinal ligaments using AED, it is often necessary to achieve further hemostasis using a bipolar device. The aim of this study is to compare the utility of two AED, BTSS and ultrasonic device, for TLH.

Methods: Our study sample included 20 patients; 11 patients that underwent TLH and resection of the upper and cardinal ligaments using the BTSS and 9 patients that underwent TLH and resection of the same ligaments using the ultrasonic device. We assessed the ligament transection time and the number of times the AED/bipolar devices were introduced and activated.

Results: There were no significant differences in the operation time or the transection times of the upper or cardinal ligaments between the groups. The number of times the AED were introduced and activated during the treatment of all ligaments did not differ significantly between the groups. However, bipolar devices were introduced and activated less often in the BTSS group during the treatment of all ligaments except the right upper ligaments.

Conclusions: Compared with TLH performed using the ultrasonic device, it is less necessary to carry out further hemostasis with bipolar devices when TLH is performed using the BTSS. We feel that the number of times the AED/bipolar devices were introduced was acceptable, and no significant differences in the operation time or the transection time of the upper or cardinal ligaments were observed between the groups.