The cavitational ultrasonic surgical aspirator for cytoreduction in advanced ovarian cancer

Abstract

The cavitational ultrasonic surgical aspirator is a newer surgical instrument that has been shown to be effective in tumor resection. The purpose of this study was to evaluate its usefulness for cytoreduction of advanced ovarian cancer. Over a 24-month period patients with advanced ovarian cancer (stage IIIC and IV or bulky recurrent disease) were studied to determine the frequency of use of the cavitational ultrasonic surgical aspirator and the sites of tumor resection. The blood loss and operative time for patients who underwent surgery with the cavitational ultrasonic surgical aspirator were compared by Student t test with those of patients who did not undergo surgery with the cavitational ultrasonic surgical aspirator. The cavitational ultrasonic surgical aspirator was utilized to effect optimal cytoreduction in 22 of 45 patients (48%). Of 52 sites of disease resected, 23 (44%) involved sites difficult to resect with standard operative techniques. These sites included the diaphragm, liver, spleen, and fixed retroperitoneal adenopathy. The cavitational ultrasonic surgical aspirator allowed resection from other sites, precluding procedures with potentially more morbidity. Of all 45 patients, 86% had cytoreduction to less than 2 cm and 44% to less than 0.5 cm. The blood loss and operative time were not different between cases in which the cavitational ultrasonic surgical aspirator was used and those in which it was not used. The cavitational ultrasonic surgical aspirator appears to contribute to cytoreduction in patients with advanced ovarian cancer.