Laparoskopická hysterektomie provedenáultrazvukovou operační technikou:prospektivní studie

Laparoscopic Hysterectomy Using UltrasonicOperative Technique: Prospective Study

Objective:
The use of the harmonic scalpel and Laparosonic Coagulating Shears (LCS) for laparos-copic hysterectomy (LH) was evaluated in thirty six women with other gynaecological conditions.Design: Prospective clinical study.Setting: Department Gynaecology and Obstetrics, Endoscopic Training Centre, Baby FriendlyHospital Kladno, Kladno, Czech Republic.Methods: Clinical data and cases of hysterectomy performed via ultrasonic operative laparoscopywere summarized and assessed. The primary hemostatic treatment was harmonic scalpel andLCS.Patients were assessed to efficacy, safety, utility and applicability of laparosonic operative techni-que.Results: From all laparoscopic procedure were 91,6% succesfully completed. There were threecases which were finished electrosurgically. The mean order of total operating time was 86,03 minand the mean order of blood loss was 170 ml (range 50 - 400 ml). There were no major complicati-ons, only one case of postoperative bleeding from vaginal cuff.Conclusion: Clinical prospective study demonstrates that ultrasonic activated technology in lapa-roscopic hysterectomy is easy to use, cost effective, and affords the surgeon a greater margin ofsafety. The harmonic scalpel produces surgical incision with concomitant hemostasis. This is onlya preliminary report, and further randomised study is needed.

Key words:
laparoscopic hysterectomy, harmonic scalpel