Application and Surgical Skill of Ultracision Harmonic Scalpel in Curative Gastrectomy for Patients with Gastric Carcinoma_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

HU Jiankun , ZHANG Bo , CHEN Xinzu , YANG Kun , CHEN Zhixin , CHEN Jiaping

Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu 610041, ChinaCorresponding Author: HU Jian-kun, E-mail: hujkwch@126.com;

Corresponding author：

Keywords：

Stomach neoplasm; Surgery; Ultracision harmonic scalpel

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Objective 　To investigate the effect and surgical skill of ultracision harmonic scalpel in curative gastrectomy for patients with gastric carcinoma.
Methods 　From January 2007 to May 2008, the data of 152 patients who were treated by curative gastrectomy with ultracision harmonic scalpel were analyzed retrospectively.
Results 　The mean operative time was (189.5±24.2) min. Compared with the conventional operation, the number of harvested lymph nodes (mean: 30.4±11.6) in patients treated with ultracision harmonic scalpel was increased. The application of ultracision harmonic scalpel could shorten the operation time, decrease the intraoperative blood loss and make the operation field clear. There were no postoperative complications, such as anastomotic leakage, lymphatic leakage and massive hemorrhage. And there was no death in this series.
Conclusion 　The usage of ultracision harmonic scalpel which could improve the curative degree of lymphadenectomy is safe in curative gastrectomy for patients with gastric carcinoma.

Citation： HU Jiankun,ZHANG Bo,CHEN Xinzu,YANG Kun,CHEN Zhixin,CHEN Jiaping. Application and Surgical Skill of Ultracision Harmonic Scalpel in Curative Gastrectomy for Patients with Gastric Carcinoma. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2008, 15(10): 718-721. doi: Copy

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2.	Martín del Olmo JC, Blanco Alvarez JI, Carbajo Caballero MA, et al. Laparoscopic appendectomy by ultrasonically activated scalpel in acute appendicitis: preliminary report [Ｊ]. J Laparoendosc Adv Surg Tech A, 2002; 12(2)∶111.
3.	魏涛, 李志辉, 朱精强. 超声刀与传统方法在开放甲状腺手术的临床对比研究 [Ｊ]. 中国普外基础与临床杂志, 2008; 15(5)∶323.
4.	Takao S, Shinchi H, Maemura K, et al. Ultrasonically activated scalpel is an effective tool for cutting the pancreas in biliary-pancreatic surgery: experimental and clinical studies [Ｊ]. J Hepatobiliary Pancreat Surg, 2000; 7(1)∶58.
5.	Gyr T, Ghezzi F, Arslanagic S, et al. Minimal invasive laparoscopic hysterectomy with ultrasonic scalpel [Ｊ]. Am J Surg, 2001; 181(6)∶516.
6.	Kusunoki M, Shoji Y, Yanagi H, et al. Transanal mucosectomy using an ultrasonically activated scalpel for ulcerative colitis [Ｊ]. Surg Today, 1999; 29(4)∶392.
7.	Kusunoki M, Shoji Y, Yanagi H, et al. Current trends in restorative proctocolectomy: introduction of an ultrasonically activated scalpel [Ｊ]. Dis Colon Rectum, 1999; 42(10)∶1349.
8.	Langer C, Liersch T, Süss M, et al. Surgical cure for early rectal carcinoma and large adenoma: transanal endoscopic microsurgery (using ultrasound or electrosurgery) compared to conventional local and radical resection [Ｊ]. Int J Colorectal Dis, 2003; 18(3)∶222.
9.	Zhou BJ, Song WQ, Yan QH, et al. Ultrasonically activated scalpel versus monopolar electrocautery shovel in laparoscopic total mesorectal excision for rectal cancer [Ｊ]. World J Gastroenterol, 2008; 14(25)∶4065.
10.	陆维祺, 赵纲, 陆巍, 等. 新型超声刀用于胃癌根治术的评价 [Ｊ]. 中国实用外科杂志, 2008; 28(3)∶203.
11.	Cancer Research UK. What is the WHO performance scale and how does this help doctors decide who can go on a clinical trial or not? (Last updated 21 July 2008). Available: www.cancerhelp.org.uk/help/default.asp?page=5566.
12.	McCarus SD. Physiologic mechanism of the ultrasonically activated scalpel [Ｊ]. J Am Assoc Gynecol Laparosc, 1996; 3(4)∶601.
13.	Strate T, Bloechle C, Broering D, et al. Hemostasis with the ultrasonically activated scalpel. Effective substitute for electrocautery in surgical patients with pacemakers [Ｊ]. Surg Endosc, 1999; 13(7)∶727.
14.	Foschi D, Cellerino P, Corsi F, et al. The mechanisms of blood vessel closure in humans by the application of ultrasonic energy [Ｊ]. Surg Endosc, 2002; 16(5)∶814.
15.	Rajbabu K, Barber NJ, Choi W, et al. To knot or not to knot? Sutureless haemostasis compared to the surgeon’s knot [Ｊ]. Ann R Coll Surg Engl, 2007; 89(4)∶359.
16.	Carlander J, Johansson K, Lindstrm S, et al. Comparison of experimental nerve injury caused by ultrasonically activated scalpel and electrosurgery [Ｊ]. Br J Surg, 2005; 92(6)∶772.
17.	Amaral JF. Ultrasound for cutting and coagulating tissue problems in general surgery [Ｊ]. Surg Ene Sour, 2002; 19(1)∶47.
18.	Nduka CC, Poland N, Kennedy M, et al. Does the ultrasonically activated scalpel release viable airborne cancer cells? [Ｊ]. Surg Endosc， 1998; 12(8)∶1031.
19.	陈峻青. 胃癌外科基础研究与扩大切除术的进展 [Ｊ]. 中国普外基础与临床杂志, 2004; 11(2)∶97.
20.	胡建昆，陈佳平，陈志新，等. 胃癌外科切除治疗（附428例报告） [Ｊ]. 四川大学学报（医学版）, 2003; 34(4)∶771.
21.	Barbour AP, Rizk NP, Gonen M, et al. Lymphadenectomy for adenocarcinoma of the gastroesophageal junction (GEJ): impact of adequate staging on outcome [Ｊ]. Ann Surg Oncol， 2007; 14(2)∶306.

1. 　Amaral JF. The experimental development of an ultrasonically activated scalpel for laparoscopic use [Ｊ]. Surg Laparosc Endosc, 1994; 4(2)∶92.
2. 　Martín del Olmo JC, Blanco Alvarez JI, Carbajo Caballero MA, et al. Laparoscopic appendectomy by ultrasonically activated scalpel in acute appendicitis: preliminary report [Ｊ]. J Laparoendosc Adv Surg Tech A, 2002; 12(2)∶111.
3. 　魏涛, 李志辉, 朱精强. 超声刀与传统方法在开放甲状腺手术的临床对比研究 [Ｊ]. 中国普外基础与临床杂志, 2008; 15(5)∶323.
4. 　Takao S, Shinchi H, Maemura K, et al. Ultrasonically activated scalpel is an effective tool for cutting the pancreas in biliary-pancreatic surgery: experimental and clinical studies [Ｊ]. J Hepatobiliary Pancreat Surg, 2000; 7(1)∶58.
5. 　Gyr T, Ghezzi F, Arslanagic S, et al. Minimal invasive laparoscopic hysterectomy with ultrasonic scalpel [Ｊ]. Am J Surg, 2001; 181(6)∶516.
6. 　Kusunoki M, Shoji Y, Yanagi H, et al. Transanal mucosectomy using an ultrasonically activated scalpel for ulcerative colitis [Ｊ]. Surg Today, 1999; 29(4)∶392.
7. 　Kusunoki M, Shoji Y, Yanagi H, et al. Current trends in restorative proctocolectomy: introduction of an ultrasonically activated scalpel [Ｊ]. Dis Colon Rectum, 1999; 42(10)∶1349.
8. 　Langer C, Liersch T, Süss M, et al. Surgical cure for early rectal carcinoma and large adenoma: transanal endoscopic microsurgery (using ultrasound or electrosurgery) compared to conventional local and radical resection [Ｊ]. Int J Colorectal Dis, 2003; 18(3)∶222.
9. 　Zhou BJ, Song WQ, Yan QH, et al. Ultrasonically activated scalpel versus monopolar electrocautery shovel in laparoscopic total mesorectal excision for rectal cancer [Ｊ]. World J Gastroenterol, 2008; 14(25)∶4065.
10. 　陆维祺, 赵纲, 陆巍, 等. 新型超声刀用于胃癌根治术的评价 [Ｊ]. 中国实用外科杂志, 2008; 28(3)∶203.
11. 　Cancer Research UK. What is the WHO performance scale and how does this help doctors decide who can go on a clinical trial or not? (Last updated 21 July 2008). Available: www.cancerhelp.org.uk/help/default.asp?page=5566.
12. 　McCarus SD. Physiologic mechanism of the ultrasonically activated scalpel [Ｊ]. J Am Assoc Gynecol Laparosc, 1996; 3(4)∶601.
13. 　Strate T, Bloechle C, Broering D, et al. Hemostasis with the ultrasonically activated scalpel. Effective substitute for electrocautery in surgical patients with pacemakers [Ｊ]. Surg Endosc, 1999; 13(7)∶727.
14. 　Foschi D, Cellerino P, Corsi F, et al. The mechanisms of blood vessel closure in humans by the application of ultrasonic energy [Ｊ]. Surg Endosc, 2002; 16(5)∶814.
15. 　Rajbabu K, Barber NJ, Choi W, et al. To knot or not to knot? Sutureless haemostasis compared to the surgeon’s knot [Ｊ]. Ann R Coll Surg Engl, 2007; 89(4)∶359.
16. 　Carlander J, Johansson K, Lindstrm S, et al. Comparison of experimental nerve injury caused by ultrasonically activated scalpel and electrosurgery [Ｊ]. Br J Surg, 2005; 92(6)∶772.
17. 　Amaral JF. Ultrasound for cutting and coagulating tissue problems in general surgery [Ｊ]. Surg Ene Sour, 2002; 19(1)∶47.
18. 　Nduka CC, Poland N, Kennedy M, et al. Does the ultrasonically activated scalpel release viable airborne cancer cells? [Ｊ]. Surg Endosc， 1998; 12(8)∶1031.
19. 　陈峻青. 胃癌外科基础研究与扩大切除术的进展 [Ｊ]. 中国普外基础与临床杂志, 2004; 11(2)∶97.
20. 　胡建昆，陈佳平，陈志新，等. 胃癌外科切除治疗（附428例报告） [Ｊ]. 四川大学学报（医学版）, 2003; 34(4)∶771.
21. 　Barbour AP, Rizk NP, Gonen M, et al. Lymphadenectomy for adenocarcinoma of the gastroesophageal junction (GEJ): impact of adequate staging on outcome [Ｊ]. Ann Surg Oncol， 2007; 14(2)∶306.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Application and Surgical Skill of Ultracision Harmonic Scalpel in Curative Gastrectomy for Patients with Gastric Carcinoma

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