结扎速血管闭合系统在重度痔切除术中的应用

目的:探讨结扎速血管闭合系统在重度痔切除术中的应用价值。方法:将158例重度痔患者随机分成甲组80例,采用结扎速血管闭合系统治疗,乙组78例,采用常规手术操作。结果:甲组的手术时间,疼痛指数,术中、术后出血量,术后肛门狭窄,均低于乙组(P0.05);两组在切口愈合时间、住院天数、切口感染率方面的差异无统计学意义(P0.05);住院费用乙组优于甲组(P0.05)。结论:结扎速血管闭合系统用于重度痔切除术,止血效果良好,手术时间短,患者术后疼痛轻,体内无异物存留。     

Ligasure血管闭合系统在痔切除手术中的应用

目的 探讨Ligasure血管闭合系统（LVSS）在痔切除手术中的应用价值。方法 对2002年12月至2003年11月间36例采用LVSS切除的病例在疼痛评分、住院时间、手术时间、住院费用、手术并发症等方面与30例传统痔切除手术进行比较。结果 两种方法的住院费用、手术并发症发生率间比较差异无统计学意义（P〉0．05）；但LVSS痔切除手术组的疼痛评分、住院时间、手术时间明显短于传统手术组（P〈0．05）。结 论LVSS具有痛苦少、安全、操作方便、创伤小和缩短手术时间等特点，可代替传统手术。     

结扎束血管闭合系统（LigaSure）在腹腔镜肝切除术中的应用价值

目的评价结扎束血管闭合系统（LigaSure）在腹腔镜肝切除术中的应用价值。方法 2009年1~10月应用LigaSure行腹腔镜肝切除术15例,其中规则性肝切除11例（Ⅱ、Ⅲ段肝切除9例,,Ⅳb肝段切除1例,Ⅵ段肝切除1例）,局部切除4例。结果 15例顺利完成手术,无中转开腹。手术时间90~300 min,（123±70）min;术中出血量30~800 ml,（100.8±60.8）ml,无严重并发症发生。术后病理均为肝细胞肝癌。15例随访6~16个月,（8.5±5.3）月,均恢复良好,腹部CT复查均未见局部复发及腹壁戳孔种植性转移。结论 LigaSure血管闭合系统用于腹腔镜肝切除术,术中止血有效,是腹腔镜肝切除手术的有力助手。     

腹腔镜全子宫切除术中结扎束血管闭合系统的应用研究

目的评估结扎束血管闭合系统(LF1537 Blunt Tip)在腹腔镜全子宫切除术中应用的临床疗效,探讨其临床价值。 方法选取解放军总医院2014年1月至2016年1月期间收治并行腹腔镜全子宫切除术患者,根据术中是否使用结扎束血管闭合系统分为观察组(使用结扎束血管闭合系统)和对照组(常规手术),记录并比较两组的一般资料和手术相关指标。 结果两组的年龄、体质量指数、腹部手术史符合正态分布且差异无统计学意义(P＝0.625、0.287、0.664);两组的疾病构成差异无统计学意义(P＝0.808)。观察组的手术时间[(46.6 ± 19.1)min vs (65.8 ± 29.2)min]和术中出血量[(51.0 ± 21.9)ml vs (118.4 ± 50.7)ml]均少于对照组,差异有统计学意义(P< 0.001);两组的输血(2例 vs 6例)、住院时间[(6.3 ± 2.2)d vs (6.7 ± 2.8) d]、中转开腹(0例 vs 2例)、并发症发生(4例 vs 7例)比较,差异无统计学意义(P＝0.204、0.391、0.182、0.472)。 结论本研究中将结扎束血管闭合系统(LF1537 Blunt Tip)应用于腹腔镜全子宫切除术,能够更加安全有效的对血管和组织进行闭合和切割,缩短了手术时间,减少了出血量,使手术更加可靠、快捷,具有重要临床应用价值。     

腹腔镜胆囊切除术中血管结扎速的应用

血管结扎速（ligasure^TM vessel sealing system）是一种新的止血切割设备，特别适合于腹腔镜下使用。我院于2005年3月～2006年7月共开展腹腔镜胆囊切除术117例，其中胆囊三角全部采用血管结扎速处理的有92例，应用体会如下。     

LigaSure血管闭合系统在腹部手术中的应用

我科于 2 0 0 1年 12月应用Valleylab公司LigaSure血管闭合系统完成腹部手术 10例 ,闭合腹内动脉、静脉及组织束。未发生术中、术后出血及其它并发症 ,效果良好 ,现报告如下。临床资料1.一般资料 :本组共 10例 ,男 6例 ,女 4例 ,年龄 2 6～ 69岁 ,平均 5 5岁。手术种类 :胃癌根治术 3例 ,右半结肠切除术 2例 ,经腹会阴直肠癌根治术 2例 ,直肠前切除术 1例 ,胃大部切除术 1例 ,空肠部分切除及阑尾切除 1例。2 .操作方法 :将需要结扎的血管分离 ,游标卡尺测量动脉血管直径后 ,用闭合钳钳夹闭合的血管 ,踩下闭合器脚踏开关 ,待听到提示音后松…     

应用LigaSure血管闭合系统行痔切除19例临床分析

疼痛和出血一直是痔切除术要解决的主要问题。LigaSure血管闭合系统是一种新型组织凝血设备，国外已成功的将LigaSure应用到痔切除术中，并取得良好的止血效果，病人术后疼痛亦明显减轻。2006年4～6月，我们应用LigaSure血管闭合系统完成痔切除术19例。现报道如下。     

LigaSure血管闭合系统在腹腔镜脾脏切除术中的应用

目的:探讨LigaSure血管闭合系统在腹腔镜脾脏切除术中的临床应用价值。方法:回顾分析2002年8月至2006年4月利用LigaSure血管闭合系统行腹腔镜脾脏切除术12例患者的临床资料。结果:用LigaSure血管闭合系统闭合处理脾动脉、脾静脉(直径<7mm)2例,丝线结扎加LigaSure血管闭合系统闭合处理脾动脉、脾静脉10例,闭合处理胃短血管、脾结肠、脾肾和脾隔韧带12例,无中转开腹、死亡病例和并发症发生,平均手术时间97min,术中平均失血89ml,患者均于术后1d开始进食,平均住院时间8.4d。结论:在腹腔镜脾脏切除术中,利用LigaSure血管闭合系统闭合处理脾动静脉、胃短血管、脾结肠和脾隔韧带安全可靠,可明显缩短手术时间,减少术中出血。     

直视下痔动脉结扎在痔Milligan—Morgan手术中的临床应用

为探讨直视下痔动脉结扎在痔MilliganMorgan手术中的临床应用价值,将152例痔（其中内痔Ⅲ期44例,Ⅳ期108例）患者随机分为对照组和观察组,各76例,对照组单纯行Milligan-Morgan手术治疗,观察组在行MilliganMorgan手术时先在直视下进行痔动脉结扎。对比观察两组患者疗效。结果显示,两组患者住院时间、创面愈合时间比较,差异均无统计学意义,P〉0．05;但观察组手术时间明显短于对照组,P〈0．05,术中出血量明显小于对照组,P〈0．01。观察组术中缝扎部位血肿3例,对照组术后创面渗血8例,两组术后均无大出血发生。随访1～2年,观察组均无复发,对照组复发10例（15．6％,10／64）。结果表明,痔Milligan—Morgan手术中先在直视下结扎痔动脉,可减少术中出血,缩短手术时间,降低术后复发率,值得临床推广应用。     

Ligasure血管闭合系统在腹腔镜肝切除手术中的初步应用

Ligasure血管闭合系统面世以来，在临床手术处理血管方面显现出其独特的优越性。2004年以来，笔者使用Ligasure血管闭合系统在腹腔镜肝切除中作了初步尝试，现报道如下。[第一段]     

中药熏洗在痔切除术后的临床运用

为探讨中药熏洗对环状混合痔外剥内扎术后创面愈合的影响,将180例环状混合痔外剥内扎术后的患者随机分为治疗组和对照组各90例,紫草油纱条换药前,两组分别采用中药和PP液熏洗坐浴,治疗组在术后疼痛指数、肛缘水肿、创面愈合时间方面均优于对照组。结果表明,中药熏洗可加速痔术后创面愈合,减轻患者痛苦和减少并发症。     

LigaSure血管闭合系统在腹腔镜肾切除手术中的应用

目的 探讨LigaSure血管闭合系统在腹腔镜肾切除术中的应用价值. 方法 2004年5月至2006年12月应用LigaSure完成41例腹腔镜下单纯肾切除术、腹腔镜根治性肾切除术及腹腔镜肾输尿管全长切除术.观察手术时间、术中出血量、是否中转开放、术后引流时间、术后引流量、术后住院时间以及并发症等情况. 结果 41例手术均获成功,无中转开放手术及严重并发症.手术时间35～240 min,平均146 min;术中出血量30～450 ml,平均163 ml;术后引流1～6 d,平均3 d;术后总引流量45～435 ml,平均229 ml;术后住院时间6～21 d,平均10 d. 结论 腹腔镜下手术中LigaSure能安全高效地闭合血管及组织束,显著减少手术时间和术中出血,缩短术后住院天数,是一种有效的血管控制系统,在腹腔镜下肾切除术中具有良好的应用前景.     

Pancreaticoduodenectomy in portal hypertension: use of the Ligasure

Background Purpose. The Ligasure Vessel Sealing System (LVSS) is a new bipolar device, put on the market in 1999, which provides safe and quick hemostasis, sealing blood vessels up to 7mm in diameter or tissue bundles without dissection or isolation. We tested this instrument in a patient with portal hypertension who had to be submitted to a complex abdominal procedure. Methods. A male patient (aged 57 years) with well-compensated cirrhosis of the liver, related to hepatitis C virus (HCV) (Child A) was diagnosed with a neoplasm of the pancreatic head. We performed a Whipple pancreaticoduodenectomy and hemostasis was almost entirely performed with the LVSS. All the blood vessels up to 7mm in diameter were sealed in this way. Larger vessels were suture ligated primarily. Results. No post-application bleeding was seen. No postoperative hemorragic complications occurred. A significant reduction in blood loss and in surgical time was noted. Conclusions. We believe that the LVSS could be extremely useful in all the fields of hepatopancreatobiliary surgery, especially in patients with portal hypertension with large intestinal and omental varices. The LVSS guarantees excellent hemostasis, reducing the risk of serious blood loss and shortening the time of surgery, so improving the prognosis.Via Cimarosa 2/a, 80127 — Naples, Italy Accepted at the fifth world congress of the International Hepato-Pancreato-Biliary Association — IHPBA     

Ligasure血管闭合系统在输卵管间质部妊娠腹腔镜手术中的应用

目的探讨腹腔镜下Ligasure治疗输卵管间质部妊娠的效果。方法对18例腹腔镜诊断为输卵管间质部妊娠病例均采用Ligasure行患侧输卵管切除术。结果均于腹腔镜下顺利完成手术,手术时间平均62（40-125）min,术中出血95（30-150）ml,术后6 h可下床活动,8-32 h肛门排气,平均住院4（3-7）d。无持续性异位妊娠发生。结论对于输卵管间质部妊娠患者,腹腔镜下用Ligasure行患侧输卵管切除术具有安全性高和止血可靠的优点,且易于学习和掌握,值得推广。     

Ligasure versus Ultracision® in thyroid surgery: a prospective randomized study

PURPOSE: New hemostatic technologies (NT) are often employed in thyroid surgery in the effort to reduce operating time and complications. The aim of this study is to compare three different hemostatic techniques. METHODS: This is a prospective randomized study. There were 150 patients, aged 56 +/- 14 years, randomized for total thyroidectomy with conventional technique (CT), Ligasure vessel sealing system (LI) or Harmonic Scalpel (HS) at the university surgical department. One hundred thirty-five patients had benign diseases; 15 had malignancies. RESULTS: Mean postoperative hospital stay was 2.6 days. Mean operation time was 113 +/- 31 min; in HS patients, it was significantly shorter (p < 0.001). Morbidity was 43.3%; mortality was nil. Morbidity was significantly different between CT and NT groups (p = 0.0002); HS and LI groups had a higher morbidity (p = 0.0001 and p = 0.02, respectively). Mean postoperative calcemia was 1.12 +/- 0.1 mmol/l with a significant difference between groups; NT patients had a significantly lower calcemia (p < 0.05). There was no difference in recurrent laryngeal nerve palsies and in intraoperative blood losses (p = ns). CONCLUSIONS: According to our experience, the only real advantage of new hemostatic technologies was a shorter operation time with HS.     

LigaSure与超声刀在全腹腔镜子宫切除术中的应用

目的探讨LigaSure与超声刀在全腹腔镜子宫切除术中的应用价值。方法回顾分析2002年1月～2006年12月225例腹腔镜全子宫切除术的临床资料,其中应用LigaSure手术152例、应用超声刀手术73例。结果LigaSure组手术时间为（104.9±29.2）min,显著短于超声刀组（152.4±46.6）min（t=-9.329,P=0.000）;LigaSure组术中出血量为（32.9±14.9）ml,显著少于超声刀组（126.4±12.1）ml（t=-46.710,P=0.000）。2组均无中转开腹,无术中副损伤及术后并发症。结论采用LigaSure和超声刀行腹腔镜子宫切除术均安全、可靠。LigaSure在处理子宫血管方面更具有优势,超声刀在打开膀胱反折和离断主韧带方面效果理想。     

舒适护理在痔术后的应用

为探讨舒适护理在痔患者术后的应用效果,对256例患者随机分为观察组和对照组各128例,对照组采用常规护理,观察组在常规护理基础上加舒适护理。结果显示,观察组无心理因素导致手术不顺利,术后肛门疼痛轻,无排便、排尿异常情况,恢复快,患者满意率70．3％,对照组满意率为41．4％（P〈0.05）。结果表明,实施舒适护理可以使患者在治疗过程中感到舒适和放松,体现了以人为本的护理宗旨。     

双荷包吻合口切断在吻合器痔切除术中的应用

为探讨双荷包及吻合口切断在吻合器痔切除术中的临床应用效果,治疗组116例行吻合器痔切除术时在齿状线上4cm及2cm分别各作一荷包缝合,并在吻合口6,9点纵行切断横行缝合;对照组86例单纯行吻合器痔切除术,比较手术效果。结果显示,治疗组无并发症发生,远、近期疗效均明显优于对照组。     

Randomized clinical trial of stapled hemorrhoidectomy vs open with Ligasure for prolapsed piles

Background The aim of the study was to compare the results in 95 patients randomly allocated to undergo either stapled or open hemorrhoidectomy using Ligasure.Methods Ninety-five patients with grade III and IV hemorrhoids were randomly allocated to undergo either stapled (50 patients) or open using Ligasure (45 patients). Stapled hemorrhoidectomy was performed with the use of a circular stapling device. Open hemorrhoidectomy was accomplished according to the Milligan-Morgan technique by using Ligasure. Postoperative pain was assessed by means of a visual analog scale (VAS). Recovery evaluation included return to pain-free defecation and normal activities. A 6-month clinical follow-up and an 18 (12-24) month median telephone follow-up were obtained in all patients.Results Operation time for open hemorrhoidectomy using Ligasure was shorter [median 13 (range 9.2-16.1) min vs 15 (range 8-17) minutes, p < 0.05]. Median range of VAS score in the stapled group were significantly lower [VAS score after 8 h: 3 (2-6) vs 5 (3-8), p < 0.01; VAS score after first defecation: 5 (3-8) vs 7 (3-9), p < 0.001. The stapled hemorrhoidectomy was associated with an increased incidence of intraoperative bleeding in 18 cases (36%) vs four cases (8.8%) of the Ligasure group. There were three cases (6%) from the stapled group with recurrence of the hemorrhoids and none from the open technique.Conclusions Hemorrhoidectomy with a circular stapler device is easy to perform, but one more line of clips must be added to the device to avoid intraoperative bleeding from the cut line. Hemorrhoidectomy performed using Ligasure is more painful postoperatively but is a more radical operation.     

Comparison of Monopolar Electrocoagulation, Bipolar Electrocoagulation, Ultracision, and Ligasure

Purpose Hemostasis is a fundamental principle of surgery. We compared the safety and efficacy of monopolar electrocoagulation (ME), bipolar electrocoagulation (BE), Ligasure (LS), a modern bipolar vessel sealing system, and Ultracision (UC), a system of ultrasound energy based shears. We also studied the healing process after their use. Methods We used each of the above methods to coagulate and divide the short gastric vessels of 16 white male New Zealand rabbits. The animals were killed after 3, 7, 14, or 21 days, and the coagulation sites and the adjacent gastric wall were examined histologically. Results LS and UC achieved complete hemostasis without any complications. Conversely, ME and BE often resulted in failed coagulation and perforation of the neighboring gastric wall from a side thermal injury. Histologically, LS demonstrated the mildest side thermal injury and the fastest healing process. We noted greater thermal injury and inflammatory response after UC than after LS on days 7 and 14; however, ME and BE caused the most severe lesions. Conclusions LS and UC are clearly the safest and most efficient methods of coagulation, whereas ME and BE could cause serious clinical and histological complications. We found histological evidence that UC causes a slightly greater inflammatory response than LS, and the clinical implications of this warrant further investigation.