Application of Method of Soft Tissue Welding in Simultaneous Laparoscopic Surgeries
The article outlines the own experience of electric welding use in simultaneous laparoscopic surgeries. Major surgeries with application of electric welding are laparoscopic cholecystectomy together with pancreatic, hepatic or spleen cyst fenestration, laparoscopic cholecystectomy and laparoscopic inguinal hernia repair. The main advantages of electric welding are the following: reduction of surgery duration, improvement of the tissue excision quality, better visualization of surgical field structures and intrasurgical blood loss decreasing.
According to World Health Organization, more than 30 % of all surgical patients are suffered from more than one surgical disorder. This category of patients is more difficult for surgical treatment, because they need two or more pathology correction. And choice of right surgical approach for patients with cholelithiasis and another surgical pathology, for example inguinal hernia or acute appendicitis, is difficult. In most cases right surgical approach in such patients is simultaneous laparoscopic operation. High risk of interoperation bleeding is a main reason, why surgeons reject simultaneous laparoscopic operations. For this purpose we use electric welding in bleeding control in patients with cholelithiasis and another surgical disorders. By using this method we could decrease blood loss in patients after laparoscopic cholecystectomy and another laparoscopic operations, for example laparoscopic hepatic cyst fenestration or laparoscopic hernia repair. Postoperative outcomes were better comparing with patients after traditional open simultaneous operations. Also using of electric welding method enables to carry out simultaneous laparoscopic operations in those patients, who previously underwent different surgical procedures on abdominal cavity. Without electric welding performing simultaneous laparoscopic operations was impossible in this category of patients. We use special «Patonmed» electric welding device, design by experts from Institute of electric welding named after Ye.O. Paton. Different modes of coagulation in this device give surgeons an ability to precisely dissect different tissues in the surgical fields, coagulate vessels of different diameters and take under control intraoperative bleeding.
During the period from 2010 to 2012 we performed 857 laparoscopic operations using «Patonmed» electric welding device. 51 patients underwent simultaneous laparoscopic operations. Women were 41, men were 10. The average age of patients was 52 years. All patients had cholelithiasis as a main disorder. For correct comparing and evaluating results we analyze treatment putcomes in those, who underwent simultaneous laparoscopic operations, but without using electric welding. Such group included 69 patients.
We obtain following results: surgery duration time was for 30–35 % smaller in patients, underwent laparoscopic simultaneous operation with electric welding, intraoperative and postoperative complications were the same in both groups, time of hospital stay after surgery also was the same. Pain severity was not different and was minimal in both groups.
We made a conclusion, that using of electric welding in surgical treatment of patients with gallbladder disorder and another surgical abdominal pathology helps to perform simultaneous laparoscopic procedure. The method of surgical approach in treatment patients with gallbladder disorder and another surgical abdominal pathology is a simultaneous laparoscopic operation using electric welding. Also using of electric welding does not reduce intraoperative and postoperative complication rate, and does not affect postoperative results in this category of patients. Procedure with electric welding device seems to be more safe, gives more technical advantages for surgeon and wider specter for performing simultaneous laparoscopic operations in patients with cholelithiasis and another different surgical disorders. Domestic electric welding technology is safe, useful and enables to achieve the same treatment standards, compare with different international analogues, but it is cheaper and device service is more available.
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