Surgical Steps of Total Laparoscopic Hysterectomy and Distinct Types of Energy

Abstract

Study Objective Show different types of energy that can be used to perform laparoscopic hysterectomy and their particularities. Design Sequential demonstration of hysterectomy steps, using different types of energy (monopolar, bipolar, advanced bipolar and ultrasonic technology) through narrated footage. Setting The use of new generation energy sources in gynecological laparoscopy is steadily increasing. In addition to conventional monopolar and bipolar electrosurgery, many surgeons use advanced bipolar or devices that use ultrasonic technology to seal vessels and tissues. The choice of instrumentation may vary according to the complexity of the surgery, in addition to previous training or experience, in addition to the availability and cost of instrumentation, as well as the appeal of the pharmaceutical industry. Patients or Participants three different cases. Interventions The first surgery focus on the use of bipolar energy with cold scissors, we show how bipolar energy allows greater security in sealing the vessels, despite greater energy dispersion with moderate area of carbonized tissue. in sequence, the use of advanced bipolar energy, where there is less energy dispersion and carbonization of the tissue, either by reading the tissue's bioimpedance and subsequently cutting through the blade of the instrument itself. Finally on the last video we can see sealing and simultaneous cutting we the use of ultrasonic energy, with gain in agility but a reduction in the sealing depth. During colpotomy the use of monopolar energy coupled to the Hulk, presents a great dispersion of energy in the dome section, but guarantees agility and good cutting power. Measurements and Main Results With the technological expansion, new types of energy appeared to improve the surgical technique. Conclusion There is still difficulty in establishing a comparative plan between the new technologies. New clinical trials with adequate power with direct comparison of the various energy sources are needed to guide surgeons in choosing the most appropriate energy source for laparoscopic hysterectomy. Show different types of energy that can be used to perform laparoscopic hysterectomy and their particularities. Sequential demonstration of hysterectomy steps, using different types of energy (monopolar, bipolar, advanced bipolar and ultrasonic technology) through narrated footage. The use of new generation energy sources in gynecological laparoscopy is steadily increasing. In addition to conventional monopolar and bipolar electrosurgery, many surgeons use advanced bipolar or devices that use ultrasonic technology to seal vessels and tissues. The choice of instrumentation may vary according to the complexity of the surgery, in addition to previous training or experience, in addition to the availability and cost of instrumentation, as well as the appeal of the pharmaceutical industry. three different cases. The first surgery focus on the use of bipolar energy with cold scissors, we show how bipolar energy allows greater security in sealing the vessels, despite greater energy dispersion with moderate area of carbonized tissue. in sequence, the use of advanced bipolar energy, where there is less energy dispersion and carbonization of the tissue, either by reading the tissue's bioimpedance and subsequently cutting through the blade of the instrument itself. Finally on the last video we can see sealing and simultaneous cutting we the use of ultrasonic energy, with gain in agility but a reduction in the sealing depth. During colpotomy the use of monopolar energy coupled to the Hulk, presents a great dispersion of energy in the dome section, but guarantees agility and good cutting power. With the technological expansion, new types of energy appeared to improve the surgical technique. There is still difficulty in establishing a comparative plan between the new technologies. New clinical trials with adequate power with direct comparison of the various energy sources are needed to guide surgeons in choosing the most appropriate energy source for laparoscopic hysterectomy.