Multi-Stream Saline-Jet Dissection Using a Simple Irrigation System Defines Difficult Tissue Planes

Durai, Rajaraman; Ng, Philip C H

doi:10.4293/108680810x12674612014545

Cited by 3 publications

(1 citation statement)

References 14 publications

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“…Argon plasma coagulation has been used in endometriosis therapy before, but the combination with injection capacity in one instrument is a novel technique, allowing a gentle and atraumatic separation of tissue planes [24]. Historically, a sharp injection cannula had to be used for this purpose, which poses the risk of organ injury.…”

Section: Discussionmentioning

confidence: 99%

Hybrid argon plasma coagulation (HybridAPC) versus sharp excision for the treatment of endometriosis: a prospective randomized clinical trial

Keckstein

Brunecker

et al. 2022

Arch Gynecol Obstet

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Purpose Endometriosis is a benign, but potentially serious gynaecological condition in terms of abdominal pain and impaired fertility. Laparoscopic excision techniques are considered the therapeutic standard. HybridAPC is presented as a novel technique for the non-contact thermal ablation of peritoneal endometriosis with simultaneous protection of the underlying thermosensitive structures by creating a needle-free elevated fluid cushion which enables a safer exposure and distance, as well as potentially improved peritoneal conditioning prior to APC. Methods In this prospective randomized clinical trial, 39 patients with 132 superficial endometriotic lesions in total were treated with HybridAPC or sharp excision in an initial laparoscopic procedure according to randomization. In a second-look laparoscopy, adhesion formation was rated macroscopically. Histologic samples were taken from previously treated areas for evaluation of eradication rate. Results The eradication rate was not significantly different between HybridAPC treatment and sharp excision (65 vs. 81%, p = .55). Adhesions formed in 5% of HybridAPC-treated lesions and in 10% after sharp excision (p = .49). HybridAPC treatment was significantly faster than sharp excision (69 vs. 106 s, p < .05). No intra- and postoperative complications were registered. Conclusion This clinical trial demonstrates the feasibility of this novel surgical technique with a promising impact on adhesion prevention. Compared to sharp excision, HybridAPC is likely to be a safe, tissue-preserving, and fast method for the treatment of peritoneal endometriosis.

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Section: Discussionmentioning

confidence: 99%

Hybrid argon plasma coagulation (HybridAPC) versus sharp excision for the treatment of endometriosis: a prospective randomized clinical trial

Keckstein

Brunecker

et al. 2022

Arch Gynecol Obstet

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A Novel Endoscopic Catheter for “Laparoscopy-Like” Irrigation and Suction: Its Research and Development Process and Clinical Evaluation

Miyazaki

Nakajima

Hosaka

et al. 2016

Journal of Laparoendoscopic & Advanced Surgical Techniques

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Hydro-dissection: An Effective Intra-Operative Technique for Difficult Laparoscopic Cholecystectomies

Ali

Shahid

Qureshi

et al. 2022

PJHS

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Hydrodissection, a technique used to treat nerve entrapments, involves injecting an anaesthetic, saline, or 5% dextrose in water to separate the nerve from the surrounding tissue. Objectives: To assess the efficacy of this technique in all patients undergoing difficult laparoscopic cholecystectomy in terms of operative time, haemorrhage, and intra-operative complications. Methods: A multicenter observational study was conducted at the department of surgery, PAF Faisal Hospital and Anis Bantva Trust Hospital Karachi. A total of 219 patients were included in this study who underwent laparoscopic cholecystectomy for symptomatic gall stones, with age ranging from 18-70 years, with intra-operative Cuschieri classification >1, using a non-probability sampling method. Results: This study included 219 patients from hospital records categorized as per intra-operative difficulty grading of Cuschieri from grade II-IV. The mean age of patients was 40.46 ±12.50 years, with an average duration of symptoms of 16.95 ± 8.73 days. There were 160 (73.1%) males and 59 (26.9%) females. About two-thirds of patients were admitted through the emergency department. The pre-operative and intraoperative diagnosis of patients was symptomatic cholelithiasis 76 (34.7%), acute on chronic cholecystitis (27.9%), chronic cholecystitis 57 (26.0%), empyema and mucocele gallbladder 11 (5%) each, and Gangrenous gallbladder 3 (1.4%) were recorded. Conclusion: This study showed a clear association of intra-operative complicated anatomy during laparoscopic cholecystectomy to its conversion to open cholecystectomy. Techniques of dissection are of significant importance to minimize injuries to vital structures

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Multi-Stream Saline-Jet Dissection Using a Simple Irrigation System Defines Difficult Tissue Planes

Abstract: A readily available, low-cost technology is described to assist in dissecting difficult tissue planes.

Cited by 3 publications

References 14 publications

Hybrid argon plasma coagulation (HybridAPC) versus sharp excision for the treatment of endometriosis: a prospective randomized clinical trial

Hybrid argon plasma coagulation (HybridAPC) versus sharp excision for the treatment of endometriosis: a prospective randomized clinical trial

A Novel Endoscopic Catheter for “Laparoscopy-Like” Irrigation and Suction: Its Research and Development Process and Clinical Evaluation

Hydro-dissection: An Effective Intra-Operative Technique for Difficult Laparoscopic Cholecystectomies

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