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首页> 外文期刊>Surgical Endoscopy >The use of bipolar cautery, laparosonic coagulating shears, and vascular clips for hemostasis of small and medium-sized vessels.
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The use of bipolar cautery, laparosonic coagulating shears, and vascular clips for hemostasis of small and medium-sized vessels.

机译：使用双极电灼，腹腔镜凝结剪和血管夹进行中小型血管止血。

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摘要

Advanced laparoscopic surgery requires a reliable method of hemostasis. In order to determine the efficacy of common hemostatic devices, we tested bipolar electrosurgery (BPES), laparosonic coagulating shears (LCS), and vascular clips (VC) on arteries of various sizes to compare the strength of hemostasis against elevated intraarterial pressure. The procedures were performed on a porcine model through a laparotomy. Segments of visceral arteries were isolated and cannulated with an angiocatheter that was linked to a pressure monitor. After hemostasis with the tested instrument and division of the vessel, the intraarterial pressure was elevated by infusion of saline solution through the angiocatheter. The pressure was recorded when bleeding occurred through the cut end of the vessel or when the pressure reached 300 mm Hg. All three devices were effective in maintaining hemostasis on small (diameter, 0.25-0.5 mm) and medium-sized arteries (diameter, 2-3.5 mm) with a success rate ranging between 75% and 100% (p = n.s.). Practice and technical finesse were required with the use of the LCS and BPES before excellent results could be obtained. The LCS has an advantage over BPES because it allows the surgeon to perform hemostasis and division simultaneously, thus keeping the operating field clean and avoiding instrument adhesion to the tissue.
机译：先进的腹腔镜手术需要可靠的止血方法。为了确定常见止血装置的功效，我们在各种大小的动脉上测试了双极电外科（BPES），腹腔高压凝结剪（LCS）和血管夹（VC），以比较止血与动脉内压升高的强度。该过程通过剖腹手术在猪模型上进行。分离内脏动脉段，并用连接至压力监测器的血管导管插管。用被测器械止血并分割血管后，通过血管导管注入盐溶液可升高动脉内压。当通过血管的切开端发生渗出时或当压力达到300mmHg时记录压力。这三种装置均能有效地维持小动脉（直径0.25-0.5 mm）和中动脉（直径2-3.5 mm）上的止血，成功率为75％至100％（p = n.s.）。使用LCS和BPES要求实践和技术精湛，才能获得出色的结果。 LCS比BPES更具优势，因为它允许外科医生同时进行止血和分裂，从而保持手术区域清洁并避免器械粘附于组织。

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