Things to keep in mind when using ultrasound knife
Views: 17 Author: Site Editor Publish Time: 2022-05-07 Origin: Site
1.Operations that must be avoided
(1) Operation under non-direct vision
As an energy tool, operation under direct vision is the most basic principle of ultrasonic knife use. Unlike open surgery, laparoscopic surgery requires close coordination between the surgeon, the assistant and the scope holder to expose the surgical field. In many cases of inaccurate target observation due to unskilled coordination and inexperience of the scope holder, the surgeon in charge should not use the ultrasonic knife blindly, as either sharp cutting or blunt freeing of the ultrasonic knife may lead to bleeding and injury of tissues and organs, which may leave consequences if not detected intraoperatively.
(2) Working with the knife head close to the vital organs
Although the ultrasonic knife produces less heat energy and less tissue damage than other energy tools such as the electric knife, it does not mean that the thermal effect of the working head has no effect on the tissue. On the contrary, operation of the working tip in close proximity to vital organs such as blood vessels and intestines may lead to late postoperative bleeding or perforation, bringing about more serious consequences than intraoperative detectable medically induced injuries.
(3) Contact with metal or bone during excitation
The ultrasonic knife works by high frequency vibration of the tip, therefore, it is important not to touch hard objects such as metal or bone during excitation, as such contact may lead to fracture and damage of the tip and may cause damage to tissues and organs.
(4) Continuous excitation for a long time
Continuous excitation for more than 10s on the tip damage, and the tissue may be scorched and carbonized. General excitation 7s should be released as far as possible, and then work again.
(5) Clamp a small amount of tissue empty excitation
If the ultrasonic knife excitation without clamping tissue or clamping a small amount of tissue, it will lead to a large area of friction between the working and non-working knife surface, and the loss of the knife head is great. Therefore, the knife head should be open when testing, and the ultrasonic knife should clamp the right amount of tissue when using.
(6) Working with crust for a long time
A small amount of tissue crust will be attached to the knife surface after using the ultrasonic knife for a long time, which affects the cutting efficiency of the ultrasonic knife on the tissue and leads to slow cutting speed and poor hemostasis effect. Therefore, the instrument care soil should use wet gauze to wipe the crust and tissue attached to the knife head in time, and put the knife head into water to shock and clean it to keep the ultrasonic knife head clean.
In summary, good exposure is the foundation, correct tension is sufficient, and the "hot knife" is taken in small steps toward the outside.
Good exposure is the basic guarantee of surgical safety, and full use should be made of the laparoscopic field of view magnification and multi-angle observation function to compensate for the loss of tactile sensation with visual advantage, and all operations must be completed under direct vision, so that "no knife is used unless you can see clearly".
Correct pulling and maintaining sufficient tension is a key skill for smooth surgery and an important technique for revealing anatomical gaps, and correct pulling depends on the tacit cooperation between the assistant and the main surgeon.
The "hot knife" facing outward in small steps is the key to reduce side injuries and improve efficiency, meaning that when using ultrasonic knife cutting, keep the working knife head facing outward and try to use the front half of the knife head to operate, dissect layer by layer and take small steps.
2.Care fit
(1) Do not use violence when installing, use torque wrench reasonably to snap it tight.
(2) Do not touch the cutter head during the test, the cutter head should be open, do not close the empty excitation.
(3) When putting the collection in the handle connecting coil, the diameter of the coil should be kept within the range of 15~20cm and should not be twisted or folded to prevent the connecting wire from being broken.
(4) After separating tissues, the instrumentation nurse should promptly wipe away the crusts and tissues attached to the knife head with wet gauze and put the knife head into water for shock cleaning to avoid damaging the silicone pad on the non-working knife surface and affecting the efficiency.
(5) During surgery, use surgical instrument placement bags around the operating table to prevent dropping and causing damage to the blade.
English
