Views: 23 Author: Site Editor Publish Time: 2022-04-29 Origin: Site
How to use ultrasonic knife
Introduction
"If you want to do a good job, you must first use a good tool". As one of the most commonly used energy tools in today's surgery, ultrasonic knife is considered a revolutionary product that influences the development of traditional surgery. It has become a common surgical tool in the hands of surgeons because of its multiple functions such as cutting, hemostasis, separation and pulling, and its good performance such as fast cutting, good hemostasis, less scab and less damage.
6 points of " use knife"
(1) Reasonable power selection
The higher the power, the faster the cut, but the poorer the hemostasis. For vessels below 2mm, the ultrasonic knife can be used to slow-file coagulation, and then in situ fast-file cutting; for 2~3mm vessels such as the superior rectal artery, it can first slow-file coagulation, and then cut off every other knife position. Although FDA-approved ultrasonic knife can close 5mm vessels, for safety reasons, 3~5mm vessels can be closed with hemostatic clips before coagulation and cut off.
(2) Proper cutting volume
Due to the long ultrasonic knife torque and weak clamping force, clamping large pieces of tissues may cause damage to the ultrasonic knife, and in addition may cause incomplete coagulation of the vessel. Clamping large pieces of tissue or excessive twisting and pulling of the knife handle after clamping tissue may cause damage to the ultrasonic knife. In addition, large pieces of clamped tissue excitation, slow cutting speed, easy to bleed, produce more fog, can not do fine dissection. Therefore, small steps should be taken and the first 2/3 of the ultrasonic knife head should be clamped.
(3) Appropriate tissue tension
Tissues that need to be sharply freed (such as thin layer of peritoneum and mesentery, etc.) can be quickly cut, fast-file striking, lightly containing the tissue with the front end of the knife head, or cutting with the back of the knife, appropriately increasing the tension, cutting speed as fast as the electric knife, and neat cutting edge; when dealing with blood vessels, avoid excessive tension, resulting in bleeding due to pulling and tearing of the coagulated blood vessels.
(4) Appropriate grip strength
The size of the grip strength can also determine the effect of cutting and hemostasis. The stronger the grip, the faster the cut, but the poorer the hemostasis.
(5) The exact direction of force
Vertical cutting in order to minimize the area of the cut surface, especially for the treatment of blood vessels, for example, the diameter of the blood vessel of 5mm 45 degrees cut, the diameter of the cut surface will become 7mm.
(6) Accurate tissue plane
The ultrasonic knife advantage can do fine dissection and is characterized by cavitation effect. For example, in colorectal tumor surgery, whether it is complete mesenteric resection or total rectal mesenteric resection, finding the correct anatomical plane, combined with cutting, incision, paddling and other knife techniques, the ultrasonic knife can navigate between the tissue planes like a butcher's knife.
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