BACKGROUND Esophageal cancer is a prevalent solid malignancy of the gastrointestinal tract.Surgical resection remains an effective intervention for prolonging patient survival.While conventional open surgery demonstra...BACKGROUND Esophageal cancer is a prevalent solid malignancy of the gastrointestinal tract.Surgical resection remains an effective intervention for prolonging patient survival.While conventional open surgery demonstrates therapeutic efficacy,it is often associated with significant tissue trauma,high complication rates,and prolonged recovery period.Advances in imaging technology and refined minimally invasive techniques have led to an increasing adoption of total thoracoscopy-assisted resection among patients.However,the efficacy of total thoracoscopic ultrasonic scalpel resection specifically for esophageal cancer patients remains unclear.AIM To evaluate the efficacy of total thoracoscopic ultrasonic scalpel resection in esophageal cancer patients.METHODS We retrospectively analyzed clinical data from 127 esophageal cancer patients undergoing total thoracoscopy-assisted resection in our hospital from January 2022 to January 2025.Based on surgical technique,61 patients subjected to total thoracoscopic electrosurgical scalpel esophagectomy were included in the control group,while 66 patients receiving total thoracoscopic ultrasonic scalpel esophagectomy were assigned to the observation group.Perioperative outcomes were compared between the two groups,including pain mediators[5-hydroxytryptamine(5-HT),potassium ions(K^(+)),norepinephrine(NE)],immune indices(CD4^(+),CD8^(+),CD4^(+)/CD8^(+)),inflammatory markers[interleukin-6(IL-6),interleukin-8(IL-8),tumor necrosis factor alpha(TNF-α)],as well as pulmonary function parameters[forced vital capacity(FVC),forced expiratory volume in one second(FEV1),maximal voluntary ventilation(MVV)].Besides,complication rates were also assessed.RESULTS Operative time was significantly shorter in the observation group compared to the control group.The observation group demonstrated reduced intraoperative blood loss and lower postoperative chest drainage volume and increased number of dissected lymph nodes(P<0.05 for all).Preoperatively,no significant differences were observed between the two groups in terms of 5-HT,K^(+),NE,CD4^(+),CD8^(+),CD4^(+)/CD8^(+),IL-6,IL-8,TNF-α,FVC,FEV1,and MVV(P>0.05).Postoperatively,both groups showed improvement in measured parameters,with the observation group exhibiting significantly better outcomes,that is,lower 5-HT,K^(+),and NE levels,higher CD4^(+)levels,lower CD8^(+)levels,and higher CD4^(+)/CD8^(+)levels(P<0.05);reduced IL-6,IL-8,and TNF-α(P<0.05);superior FVC,FEV1,and MVV measurements(P<0.05).The total complication rate was significantly lower in the observation group(7.58%vs 21.31%;P<0.05).CONCLUSION Total thoracoscopic ultrasonic scalpel resection demonstrates superior surgical outcomes in esophageal cancer patients compared to electrosurgical techniques.This approach significantly improves perioperative indicators,ameliorates postoperative pain,enhances immune function,alleviates inflammatory responses,and preserves pulmonary function,demonstrating the safety and reliability of this technique in esophageal cancer patients.展开更多
The headquarters of Plutus Financial Group Ltd,based in Hong Kong of China,stands as a silent yet razorsharp marker—rooted deeply in the heart of traditional finance,while piercing boundaries,exploring the vast nebul...The headquarters of Plutus Financial Group Ltd,based in Hong Kong of China,stands as a silent yet razorsharp marker—rooted deeply in the heart of traditional finance,while piercing boundaries,exploring the vast nebulae of blockchain and artificial intelligence.This integrated financial services group,newly listed on Nasdaq this February,is moving through the cut-and-thrust of the capital market with the postureof a"white knight."展开更多
Minimal invasive techniques have allowed for major surgical advances.We report our initial experience of performing total laparoscopic left hepatectomy(segmentsⅡ-Ⅳ)with the Lotus(laparoscopic operation by torsional ...Minimal invasive techniques have allowed for major surgical advances.We report our initial experience of performing total laparoscopic left hepatectomy(segmentsⅡ-Ⅳ)with the Lotus(laparoscopic operation by torsional ultrasound)Ultrasonic Scalpel.The perioperative and postoperative courses of the young female patient were uneventful and she is in a good general condition without complaints 18 mo after surgery.To the best of our knowledge,this is the first total laparoscopic hemihepatectomy to be performed in Greece,as well as the first laparoscopic liver resection using Lotus shears.展开更多
AIM:To compare hemorrhoidectomy with a bipolar electrothermal device or hemorrhoidectomy using an ultrasonically activated scalpel.METHODS:Sixty patients with grade Ⅲ or Ⅳ hemorrhoids were prospectively randomized t...AIM:To compare hemorrhoidectomy with a bipolar electrothermal device or hemorrhoidectomy using an ultrasonically activated scalpel.METHODS:Sixty patients with grade Ⅲ or Ⅳ hemorrhoids were prospectively randomized to undergo closed hemorrhoidectomy assisted by bipolar diathermy(group 1) or hemorrhoidectomy with the ultrasonic scalpel(group 2).Operative data were recorded,and patients were followed at 1,3,and 6 wk to evaluate complications.Independent assessors were assigned to obtain postoperative pain scores,oral analgesic requirement and satisfaction scores.RESULTS:Reduced intraoperative blood loss median 0.9 mL(95% CI:0.8-3.7) vs 4.6 mL(95% CI:3.8-7.0),P = 0.001 and a short operating time median 16(95% CI:14.6-18.2) min vs 31(95% CI:28.1-35.3) min,P < 0.0001 was observed in group 1 compared with group 2.There was a trend towards lower postoperative pain scores on day 1 group 1 median 2(95% CI:1.8-3.5) vs group 2 median 3(95% CI:2.6-4.2),P = 0.135.Reduced oral analgesic requirement during postoperative 24 h after operation median 1(95% CI:0.4-0.9) tablet vs 1(95% CI:0.9-1.3) tablet,P = 0.006 was observed in group 1 compared with group 2.There was no difference between the two groups in the degree of patient satisfaction or number of postoperative complications.CONCLUSION:Bipolar diathermy hemorrhoidectomy is quick and bloodless and,although as painful as closed hemorrhoidectomy with the ultrasonic scalpel,is associated with a reduced analgesic requirement immediately after operation.展开更多
Male circumcision is one of the most commonly performed operations worldwide, and many novel techniques have been developed for better postoperative outcomes. The purpose of this study was to explore the feasibility o...Male circumcision is one of the most commonly performed operations worldwide, and many novel techniques have been developed for better postoperative outcomes. The purpose of this study was to explore the feasibility of applying the ultracision harmonic scalpel （UHS） for circumcision by using dogs. Sixteen adult male dogs were divided into two groups： the UHS group and the control group. The dogs were circumcised with either the UHS or a conventional scalpel. The UHS circumcision procedure and the effects were imaged 1 week after surgery. The two groups were compared with respect to the operative time and volume of blood loss. Postoperative complications, including oedema, infection, bleeding of the incision and wound dehiscence, were recorded for both groups. The mean operative time for the UHS group was only 5.1 min compared with the 35.5 min of the conventional group. The mean blood loss was less than 2 ml for the UHS group and 15 ml for the conventional group. There was only one case of mild oedema in the UHS group, but the postoperative complications in the conventional group included two cases of mild oedema, one infection of the incision and one Case of bleeding of the incision. In conclusion, circumcision using UHS is a novel technique to treat patients with phimosis and excessive foreskin, and this method has a short operative time, less blood loss and fewer complications than the conventional scalpel method. This small animal study orovides a basis for embarking on a larger-scale clinical trial of the UHS.展开更多
Gastrointestinal stroma tumours(GIST) are the most common mesenchymal tumour in the digestive tract and commonly found in the stomach. The patient described in this report presented with collapse and a palpable abdomi...Gastrointestinal stroma tumours(GIST) are the most common mesenchymal tumour in the digestive tract and commonly found in the stomach. The patient described in this report presented with collapse and a palpable abdominal mass. He was found to have a large gastric GIST that penetrated through the mesocolon. Resection of the GIST was technically challenging but facilitated by a new generation ultrasonic scalpel device. In resection of gastric cancer the use of ultrasonic scalpels has been shown to reduce operating time, blood loss and length of stay. We feel that in technically challenging cases of gastric GIST the use of an ultrasonic scalpel device may be justified as well.展开更多
Objective:The present study aims to compare the clinical efficacy of laparoscopic partial nephrectomy using a harmonic scalpel versus traditional scissor.Methods:A retrospective review was conducted in patients with l...Objective:The present study aims to compare the clinical efficacy of laparoscopic partial nephrectomy using a harmonic scalpel versus traditional scissor.Methods:A retrospective review was conducted in patients with localized renal tumors and scheduled for laparoscopic partial nephrectomy from January 2015 to December 2019.Eventually,225 patients joined this retrospective study.Patients were divided into the harmonic scalpel group or scissor group based on the method used,with 71 cases and 154 cases respectively.Propensity score matching(1:1)was performed to adjust for potential baseline confounders,and each group had 57 cases.Patient characteristics,perioperative clinical results,complications,and oncological results were compared between the two groups.Results:After matching,patient characteristics were not significantly different between the two groups.The scissor group was associated with a significantly shorter operative time(105 min vs.130 min,p<0.001),shorter warm ischemia time(19.35 min vs.22.07 min,p?0.005).However,the harmonic scalpel group was associated with significantly less estimated blood loss(20 mL vs.30 mL,p?0.013)and shorter length of stay(8 d vs.10 d,p?0.040).There was no significantly difference in indwelling time of drainage tube,perioperative complication,oncological outcomes or recurrence rates.Conclusions:The harmonic scalpel is used safely and effectively in laparoscopic partial nephrectomy,and has benefits in intraoperative blood loss and length of stay.展开更多
In response to the ultrasonic scalpels with the vibrational modal coupling which leads to a decrease in efficiency,an ultrasonic scalpel based on fusiform phononic crystals(PnCs)is proposed.An accurate theoretical mod...In response to the ultrasonic scalpels with the vibrational modal coupling which leads to a decrease in efficiency,an ultrasonic scalpel based on fusiform phononic crystals(PnCs)is proposed.An accurate theoretical model is constructed,which is mainly composed of electromechanical equivalent circuit models to analyze the frequency response function and the frequency response curves of the admittance.Bragg band gaps exist in the fusiform PnCs owing to the periodic constraint,which can suppress the corresponding vibrational modes.The vibration characteristics(vibration mode,frequency,and displacement distribution)of the ultrasonic scalpel are analyzed,and the validity of the electromechanical equivalent circuit method is verified.The results indicate that other vibration modes near the working frequency can be isolated.In addition,blades based on fusiform PnCs have a function akin to that of the horn,which enables displacement amplification.展开更多
Ultrasonic scalpel design for minimally invasive surgical procedures is mainly focused on optimizing cutting performance.However,an important issue is the low fatigue life of traditional ultrasonic scalpels,which affe...Ultrasonic scalpel design for minimally invasive surgical procedures is mainly focused on optimizing cutting performance.However,an important issue is the low fatigue life of traditional ultrasonic scalpels,which affects their long-term reliability and effectiveness and creates hidden dangers for surgery.In this study,a multi-objective optimal design for the cutting performance and fatigue life of ultrasonic scalpels was proposed using finite element analysis and fatigue simulation.The optimal design parameters of resonance frequency and amplitude were determined.By setting the transition fillet and keeping the gain structure away from the node position to enable the scalpel to have a high service life with excellent cutting performance.The frequency modulation method of setting the vibration node bosses at the node position and setting the vibration antinode grooves at the antinode position was compared.Then,the mechanism of the influence of various design elements,such as tip,shank,node position,and antinode position,on the resonance frequency,amplitude,and fatigue life of the ultrasonic scalpel was analyzed,and the optimal design principles of the ultrasonic scalpel were obtained.The proposed ultrasonic scalpel design was confirmed by simulations,impedance measurements,and liver tissue cutting experiments,demonstrating its feasibility and enhanced performance.This research introduces innovative design strategies to improve the fatigue life and performance of ultrasonic scalpels to address an important issue in minimally invasive surgery.展开更多
Since 1985, the no-scalpel vasectomy technique has been widely used outside China. The prevalence of this tech-nique has helped to increase the acceptability of male sterilization in many parts of the world. More than...Since 1985, the no-scalpel vasectomy technique has been widely used outside China. The prevalence of this tech-nique has helped to increase the acceptability of male sterilization in many parts of the world. More than 5000 physi-cians in twenty-five developing countries have been trained in the no-scalpel vasectomy technique. In the United Statesin 1995, nearly one third of vasectomies employed the no-scalpel technique, and in the whole Northern American re-gion, a total of 1100 doctors have been made familiar with the technique. Doctors believe that there are several advan-tages of the no-scalpel technique, including no incision, no stitches, faster procedure, faster recovery, less chance ofbleeding, less discomfort and high efficacy. The key steps of the technique include fixation of the vas and infiltrationanaesthesia of the spermatic cord, as well as grasping, delivering and isolating the vas. No-scalpel technique providesa good approach to expose the vas, in conjunction with which, different vas-end occlusion methods may be used.(Asian J Androl 2000; 2: 21 - 24)展开更多
Objectives: To investigate the evaluation of the harmonic scalpel-assisted uvulopalatopharyn-goplasty (UPPP) surgery with posterior wall of uvula mucosa sutured with anterior wall. Design: According to the diagnostic ...Objectives: To investigate the evaluation of the harmonic scalpel-assisted uvulopalatopharyn-goplasty (UPPP) surgery with posterior wall of uvula mucosa sutured with anterior wall. Design: According to the diagnostic criteria published by Chinese medical association of otolaryngology-head and neck, 21 cases were performed UPPP with the harmonic scalpel. The Regional Ethics Committee of our hospital approved the study protocol. Informed written consent was obtained from all participants. Setting: A single specialist hospital. Participants: 21 patients with OSAHS. Participants were not randomized in groups and were performed UPPP with the harmonic scalpel. Main Outcome Measures: Part of the uvula muscle and the anterior wall of the uvula mucosa were removed, and the mucosa of posterior wall was preserved. The mucosa of the posterior wall was sutured with the remaining part of the anterior wall. The AHI and LaSO<sub>2</sub> were measured both before and six months after the operation by Polysomnography (PSG). Results: This study reported a significant improvement (p ± s) was 48.6 ± 12.65, and LSaO<sub>2</sub> (± s) was 67.4% ± 9.18%;postoperative AHI was 10.9 ± 9.29, and postoperative LSaO<sub>2</sub> was 91.0 ± 1.47. The mean operation duration was 30.1 minutes. Conclusion: The use of HS in UPPP is efficient and shows some advantages over conventional method: its use provided a blood free surgery field, and shorter operation duration.展开更多
Purpose: To evaluate the application of a high-frequency electrosurgical scalpel and methylene blue staining in the endonasal dacryocystorhinostomy.Methods: This retrospective study included 37 patients(43eyes).underg...Purpose: To evaluate the application of a high-frequency electrosurgical scalpel and methylene blue staining in the endonasal dacryocystorhinostomy.Methods: This retrospective study included 37 patients(43eyes).undergoing endonasal dacryocystorhinostomy in our hospital between 2011 and 2013 using methylene blue staining of the lacrimal sac and a high-frequency electrosurgical scalpel for cutting nasal mucosa, intraoperative stanch, and fixation of lacrimal sac and nasal mucosal flaps. Surgical efficacy, intraoperative challenges, and corresponding handling methods were evaluated and summarized.Results: Among 43 eyes, 42 were successfully cured(97.7%)and the symptoms in 1 eye were improved(2.3%). Total efficacy rate was 100%. All surgeries were successfully performed. No severe intraoperative complications were observed.Conclusion: A high-frequency electrosurgical scalpel, combined with methylene blue staining of the lacrimal sac, is efficacious for nasal mucosal cutting, intraoperative stanch, and fixation of mucosal flap by cauterization, which significantly alleviates intraoperative complications and enhances surgical success rate. It deserves widespread application in clinical practice.展开更多
Objective To investigate the applied value of the ultrasonic scalpel in gynecologic operative laparoscopy. Methods Gynecologic operations were performed using the ultrasonic scalpel under laparoscopy. Operative bleedi...Objective To investigate the applied value of the ultrasonic scalpel in gynecologic operative laparoscopy. Methods Gynecologic operations were performed using the ultrasonic scalpel under laparoscopy. Operative bleeding and time, perioperative body temperature and hemogram, and tissue damage were observed.Results Forty-two cases of benign gynecologic diseases were treated with the ultrasonic scalpel under laparoscopy. Among them, there were 4 hysterectomies, 9 ovarian cystectomies, 18 salpingotomies, 4 ectopic pregnancies, 3 myomectomies, 3 adhesiolysis and 1 adnexectomy. The amount of operative bleeding, operating time and the tissue injury were related to the type of operation. The minimual operative bleeding amount, operating time, depth of tissue necrosis, tissue injury score and fibrin deposition score were 24.77±4.71ml, 23.39±3.01 min, 0.22±0.10mm, 0.98±0.21 and 0.38±0.26, respectively. The maximal operative bleeding amount, operating time, depth of tissue necrosis, tissue injury score and fibrin deposition score were 166.7±47.18ml, 127.2±16.99 min, 0.35±0.20mm, 1.25±0.20 and 0.81±0.29, respectively. The levels of body temperature, white blood cells and hemoglobin before and after the operations were not statistically different (P>0.05) except for hysterectomy (P<0.05). Conclusion The ultrasonic scalpel can be safely applied for gynecologic operative laparoscopy and should be used widely.展开更多
The ultrasonic bone scalpel was often used in all kinds of clinical orthopedic surgery as a new type of medical instrument.Based on the working theory of the ultrasonic bone scalpel and combined with the design method...The ultrasonic bone scalpel was often used in all kinds of clinical orthopedic surgery as a new type of medical instrument.Based on the working theory of the ultrasonic bone scalpel and combined with the design method of a quarter wavelength transducer and horn,this study proposed an optimization design method for the ultrasonic bone scalpel with a composite horn structure.The structure of the ultrasonic bone scalpel was simplified,and its length was shortened.Finite element analysis,modal analysis,and harmonic response analysis were used to optimize the design of the ultrasonic bone scalpel.The performance of the ultrasonic bone scalpel was explored through impedance analysis,amplitude measurement,temperature measurement,and cutting tests,and the feasibility of the design was verified through torque analysis.The results showed that when the torque force was 4.0 N,the resonance frequency of the ultrasonic bone scalpel was 30,540 Hz,and the maximum amplitude of the ultrasonic bone scalpel could reach 62μm.After spray cooling,the maximum surface temperature of the rear end cover was reduced from 51.8 to 36.3℃,the maximum surface temperature of the composite horn was reduced from 71 to 45.3℃,and the maximum surface temperature of the cutter head was reduced from 101 to 46.1℃,demonstrating a good cooling effect.Under 89 Voltage,the optimal cutting force for cutting chicken leg bones was 0.1 N,the optimal cutting force for cutting pork ribs was 0.3 N,and the cutting process showed tissue selectivity.展开更多
The harmonic scalpel is a hemostatic device primarily designed for use in laparoscopic surgery.During the last few years,many surgeons have begun to use the harmonic scalpel in open surgery.Several papers have cited t...The harmonic scalpel is a hemostatic device primarily designed for use in laparoscopic surgery.During the last few years,many surgeons have begun to use the harmonic scalpel in open surgery.Several papers have cited the benefits of the device compared with conventional knot-tying techniques;however,no evidence showing the advantages of using the harmonic scalpel in complicated abdominal aortic aneurysm(AAA)surgery has been presented.The aim of the present study is to determine the value of the harmonic scalpel in open operation for AAA.A total of 153 patients who underwent open surgery for AAA at the Department of Vascular Surgery of Guangdong General Hospital,China between January 2001 and December 2010,were retrospectively analyzed.Open surgery performed with the harmonic scalpel on 105 patients was compared with open operation using conventional knot-tying techniques on 48 patients.The operative time,intraoperative blood loss,total postoperative drainage fluid volumes,hospital stay,and postoperative complications between the two groups were compared.The harmonic scalpel group was associated with a shorter operation time(113.2±23.6 min vs.232.1±39.2 min,P<0.01)and lower intraoperative blood loss(126.1±96.6 ml vs.592.1±207.2 ml,P<0.01).Postoperative drainage fluid volumes were greater in the conventional surgery group than in the harmonic scalpel group(702.1±192.8 ml vs.198.5±97.4 ml,P<0.01).The hospital stay was shorter for the harmonic scalpel group than for the conventional surgery group(10.7±3.3 d vs.16.5±4.7 d,P<0.05).No differences between the postoperative complications or hospital mortality of the two groups were found.The harmonic scalpel is a safe and minimally invasive tool in open surgery for AAA and is associated with shorter operative time,shorter hospital stay,and lower intraoperative blood loss and postoperative drainage fluid volumes compared with conventional knot-tying techniques.展开更多
目的:设计一种具有功率调节与频率跟踪功能的超声手术刀电源,以解决现有的超声手术刀电源驱动效果不佳的问题。方法:超声手术刀电源硬件由主电路、直接数字式合成器(direct digital synthesizer,DDS)信号发生电路和反馈电路等组成。主...目的:设计一种具有功率调节与频率跟踪功能的超声手术刀电源,以解决现有的超声手术刀电源驱动效果不佳的问题。方法:超声手术刀电源硬件由主电路、直接数字式合成器(direct digital synthesizer,DDS)信号发生电路和反馈电路等组成。主电路由功率调节电路和半桥逆变电路组成,其中功率调节电路由Buck降压电路和TL494芯片驱动电路组成;DDS信号发生电路由死区电路与IR2110芯片驱动电路组成;反馈电路由信号采集电路和信号处理电路组成。该电源采用TL494芯片驱动Buck降压电路实现功率调节,采用最大电流法与锁相法实现频率跟踪。该电源软件采用Keil软件开发系统编程。为验证该电源样机的性能,进行功率调节实验、频率跟踪实验和切割实验。结果:功率调节实验和频率跟踪实验显示,该电源样机能实现功率的大范围(4%~96%占空比)连续无级调节与54 500~57 500 Hz范围的频率自动跟踪;切割实验显示,猪里脊、猪肝生物样本表面切口完整,无烧焦情况。结论:该超声手术刀电源工作稳定、驱动效果较好,可满足设计要求。展开更多
The emergent light distribution of a new type of contact laser scalpel is measured in three different states using a light sensor. The relationship between the angle and the light intensity is analyzed. The results sh...The emergent light distribution of a new type of contact laser scalpel is measured in three different states using a light sensor. The relationship between the angle and the light intensity is analyzed. The results show that the strongest light is emitted from two sides and the front of the scalpel. The light from the front mainly plays a role of cutting. The light from two sides contributes to stanch the wound so as to remain a clear visual field during the surgery. It also helps to increase the cutting efficiency.展开更多
文摘BACKGROUND Esophageal cancer is a prevalent solid malignancy of the gastrointestinal tract.Surgical resection remains an effective intervention for prolonging patient survival.While conventional open surgery demonstrates therapeutic efficacy,it is often associated with significant tissue trauma,high complication rates,and prolonged recovery period.Advances in imaging technology and refined minimally invasive techniques have led to an increasing adoption of total thoracoscopy-assisted resection among patients.However,the efficacy of total thoracoscopic ultrasonic scalpel resection specifically for esophageal cancer patients remains unclear.AIM To evaluate the efficacy of total thoracoscopic ultrasonic scalpel resection in esophageal cancer patients.METHODS We retrospectively analyzed clinical data from 127 esophageal cancer patients undergoing total thoracoscopy-assisted resection in our hospital from January 2022 to January 2025.Based on surgical technique,61 patients subjected to total thoracoscopic electrosurgical scalpel esophagectomy were included in the control group,while 66 patients receiving total thoracoscopic ultrasonic scalpel esophagectomy were assigned to the observation group.Perioperative outcomes were compared between the two groups,including pain mediators[5-hydroxytryptamine(5-HT),potassium ions(K^(+)),norepinephrine(NE)],immune indices(CD4^(+),CD8^(+),CD4^(+)/CD8^(+)),inflammatory markers[interleukin-6(IL-6),interleukin-8(IL-8),tumor necrosis factor alpha(TNF-α)],as well as pulmonary function parameters[forced vital capacity(FVC),forced expiratory volume in one second(FEV1),maximal voluntary ventilation(MVV)].Besides,complication rates were also assessed.RESULTS Operative time was significantly shorter in the observation group compared to the control group.The observation group demonstrated reduced intraoperative blood loss and lower postoperative chest drainage volume and increased number of dissected lymph nodes(P<0.05 for all).Preoperatively,no significant differences were observed between the two groups in terms of 5-HT,K^(+),NE,CD4^(+),CD8^(+),CD4^(+)/CD8^(+),IL-6,IL-8,TNF-α,FVC,FEV1,and MVV(P>0.05).Postoperatively,both groups showed improvement in measured parameters,with the observation group exhibiting significantly better outcomes,that is,lower 5-HT,K^(+),and NE levels,higher CD4^(+)levels,lower CD8^(+)levels,and higher CD4^(+)/CD8^(+)levels(P<0.05);reduced IL-6,IL-8,and TNF-α(P<0.05);superior FVC,FEV1,and MVV measurements(P<0.05).The total complication rate was significantly lower in the observation group(7.58%vs 21.31%;P<0.05).CONCLUSION Total thoracoscopic ultrasonic scalpel resection demonstrates superior surgical outcomes in esophageal cancer patients compared to electrosurgical techniques.This approach significantly improves perioperative indicators,ameliorates postoperative pain,enhances immune function,alleviates inflammatory responses,and preserves pulmonary function,demonstrating the safety and reliability of this technique in esophageal cancer patients.
文摘The headquarters of Plutus Financial Group Ltd,based in Hong Kong of China,stands as a silent yet razorsharp marker—rooted deeply in the heart of traditional finance,while piercing boundaries,exploring the vast nebulae of blockchain and artificial intelligence.This integrated financial services group,newly listed on Nasdaq this February,is moving through the cut-and-thrust of the capital market with the postureof a"white knight."
文摘Minimal invasive techniques have allowed for major surgical advances.We report our initial experience of performing total laparoscopic left hepatectomy(segmentsⅡ-Ⅳ)with the Lotus(laparoscopic operation by torsional ultrasound)Ultrasonic Scalpel.The perioperative and postoperative courses of the young female patient were uneventful and she is in a good general condition without complaints 18 mo after surgery.To the best of our knowledge,this is the first total laparoscopic hemihepatectomy to be performed in Greece,as well as the first laparoscopic liver resection using Lotus shears.
文摘AIM:To compare hemorrhoidectomy with a bipolar electrothermal device or hemorrhoidectomy using an ultrasonically activated scalpel.METHODS:Sixty patients with grade Ⅲ or Ⅳ hemorrhoids were prospectively randomized to undergo closed hemorrhoidectomy assisted by bipolar diathermy(group 1) or hemorrhoidectomy with the ultrasonic scalpel(group 2).Operative data were recorded,and patients were followed at 1,3,and 6 wk to evaluate complications.Independent assessors were assigned to obtain postoperative pain scores,oral analgesic requirement and satisfaction scores.RESULTS:Reduced intraoperative blood loss median 0.9 mL(95% CI:0.8-3.7) vs 4.6 mL(95% CI:3.8-7.0),P = 0.001 and a short operating time median 16(95% CI:14.6-18.2) min vs 31(95% CI:28.1-35.3) min,P < 0.0001 was observed in group 1 compared with group 2.There was a trend towards lower postoperative pain scores on day 1 group 1 median 2(95% CI:1.8-3.5) vs group 2 median 3(95% CI:2.6-4.2),P = 0.135.Reduced oral analgesic requirement during postoperative 24 h after operation median 1(95% CI:0.4-0.9) tablet vs 1(95% CI:0.9-1.3) tablet,P = 0.006 was observed in group 1 compared with group 2.There was no difference between the two groups in the degree of patient satisfaction or number of postoperative complications.CONCLUSION:Bipolar diathermy hemorrhoidectomy is quick and bloodless and,although as painful as closed hemorrhoidectomy with the ultrasonic scalpel,is associated with a reduced analgesic requirement immediately after operation.
文摘Male circumcision is one of the most commonly performed operations worldwide, and many novel techniques have been developed for better postoperative outcomes. The purpose of this study was to explore the feasibility of applying the ultracision harmonic scalpel （UHS） for circumcision by using dogs. Sixteen adult male dogs were divided into two groups： the UHS group and the control group. The dogs were circumcised with either the UHS or a conventional scalpel. The UHS circumcision procedure and the effects were imaged 1 week after surgery. The two groups were compared with respect to the operative time and volume of blood loss. Postoperative complications, including oedema, infection, bleeding of the incision and wound dehiscence, were recorded for both groups. The mean operative time for the UHS group was only 5.1 min compared with the 35.5 min of the conventional group. The mean blood loss was less than 2 ml for the UHS group and 15 ml for the conventional group. There was only one case of mild oedema in the UHS group, but the postoperative complications in the conventional group included two cases of mild oedema, one infection of the incision and one Case of bleeding of the incision. In conclusion, circumcision using UHS is a novel technique to treat patients with phimosis and excessive foreskin, and this method has a short operative time, less blood loss and fewer complications than the conventional scalpel method. This small animal study orovides a basis for embarking on a larger-scale clinical trial of the UHS.
文摘Gastrointestinal stroma tumours(GIST) are the most common mesenchymal tumour in the digestive tract and commonly found in the stomach. The patient described in this report presented with collapse and a palpable abdominal mass. He was found to have a large gastric GIST that penetrated through the mesocolon. Resection of the GIST was technically challenging but facilitated by a new generation ultrasonic scalpel device. In resection of gastric cancer the use of ultrasonic scalpels has been shown to reduce operating time, blood loss and length of stay. We feel that in technically challenging cases of gastric GIST the use of an ultrasonic scalpel device may be justified as well.
基金This study was funded by Medical Health Science and Technology Project of Zhejiang Provincial Health Commission(2020375998).
文摘Objective:The present study aims to compare the clinical efficacy of laparoscopic partial nephrectomy using a harmonic scalpel versus traditional scissor.Methods:A retrospective review was conducted in patients with localized renal tumors and scheduled for laparoscopic partial nephrectomy from January 2015 to December 2019.Eventually,225 patients joined this retrospective study.Patients were divided into the harmonic scalpel group or scissor group based on the method used,with 71 cases and 154 cases respectively.Propensity score matching(1:1)was performed to adjust for potential baseline confounders,and each group had 57 cases.Patient characteristics,perioperative clinical results,complications,and oncological results were compared between the two groups.Results:After matching,patient characteristics were not significantly different between the two groups.The scissor group was associated with a significantly shorter operative time(105 min vs.130 min,p<0.001),shorter warm ischemia time(19.35 min vs.22.07 min,p?0.005).However,the harmonic scalpel group was associated with significantly less estimated blood loss(20 mL vs.30 mL,p?0.013)and shorter length of stay(8 d vs.10 d,p?0.040).There was no significantly difference in indwelling time of drainage tube,perioperative complication,oncological outcomes or recurrence rates.Conclusions:The harmonic scalpel is used safely and effectively in laparoscopic partial nephrectomy,and has benefits in intraoperative blood loss and length of stay.
基金supported by the National Natural Science Foundation of China(Grant Nos.62204112,12174240,and 11874253)the Natural Science Foundation of Jiangsu Province,China(Grant No.BK20220774).
文摘In response to the ultrasonic scalpels with the vibrational modal coupling which leads to a decrease in efficiency,an ultrasonic scalpel based on fusiform phononic crystals(PnCs)is proposed.An accurate theoretical model is constructed,which is mainly composed of electromechanical equivalent circuit models to analyze the frequency response function and the frequency response curves of the admittance.Bragg band gaps exist in the fusiform PnCs owing to the periodic constraint,which can suppress the corresponding vibrational modes.The vibration characteristics(vibration mode,frequency,and displacement distribution)of the ultrasonic scalpel are analyzed,and the validity of the electromechanical equivalent circuit method is verified.The results indicate that other vibration modes near the working frequency can be isolated.In addition,blades based on fusiform PnCs have a function akin to that of the horn,which enables displacement amplification.
基金Supported by National Natural Science Foundation of China (Grant Nos.52005199,42241149)Shenzhen Fundamental Research Program of China (Grant Nos.JCYJ20200109150425085,JCYJ20220818102601004)+1 种基金Knowledge Innovation Program of Wuhan-Basic Research of China (Grant No.2022010801010203)Shenzhen Science and Technology Program of China (Grant Nos.JSGG20201103100001004,JSGG20220831105800001)。
文摘Ultrasonic scalpel design for minimally invasive surgical procedures is mainly focused on optimizing cutting performance.However,an important issue is the low fatigue life of traditional ultrasonic scalpels,which affects their long-term reliability and effectiveness and creates hidden dangers for surgery.In this study,a multi-objective optimal design for the cutting performance and fatigue life of ultrasonic scalpels was proposed using finite element analysis and fatigue simulation.The optimal design parameters of resonance frequency and amplitude were determined.By setting the transition fillet and keeping the gain structure away from the node position to enable the scalpel to have a high service life with excellent cutting performance.The frequency modulation method of setting the vibration node bosses at the node position and setting the vibration antinode grooves at the antinode position was compared.Then,the mechanism of the influence of various design elements,such as tip,shank,node position,and antinode position,on the resonance frequency,amplitude,and fatigue life of the ultrasonic scalpel was analyzed,and the optimal design principles of the ultrasonic scalpel were obtained.The proposed ultrasonic scalpel design was confirmed by simulations,impedance measurements,and liver tissue cutting experiments,demonstrating its feasibility and enhanced performance.This research introduces innovative design strategies to improve the fatigue life and performance of ultrasonic scalpels to address an important issue in minimally invasive surgery.
文摘Since 1985, the no-scalpel vasectomy technique has been widely used outside China. The prevalence of this tech-nique has helped to increase the acceptability of male sterilization in many parts of the world. More than 5000 physi-cians in twenty-five developing countries have been trained in the no-scalpel vasectomy technique. In the United Statesin 1995, nearly one third of vasectomies employed the no-scalpel technique, and in the whole Northern American re-gion, a total of 1100 doctors have been made familiar with the technique. Doctors believe that there are several advan-tages of the no-scalpel technique, including no incision, no stitches, faster procedure, faster recovery, less chance ofbleeding, less discomfort and high efficacy. The key steps of the technique include fixation of the vas and infiltrationanaesthesia of the spermatic cord, as well as grasping, delivering and isolating the vas. No-scalpel technique providesa good approach to expose the vas, in conjunction with which, different vas-end occlusion methods may be used.(Asian J Androl 2000; 2: 21 - 24)
文摘Objectives: To investigate the evaluation of the harmonic scalpel-assisted uvulopalatopharyn-goplasty (UPPP) surgery with posterior wall of uvula mucosa sutured with anterior wall. Design: According to the diagnostic criteria published by Chinese medical association of otolaryngology-head and neck, 21 cases were performed UPPP with the harmonic scalpel. The Regional Ethics Committee of our hospital approved the study protocol. Informed written consent was obtained from all participants. Setting: A single specialist hospital. Participants: 21 patients with OSAHS. Participants were not randomized in groups and were performed UPPP with the harmonic scalpel. Main Outcome Measures: Part of the uvula muscle and the anterior wall of the uvula mucosa were removed, and the mucosa of posterior wall was preserved. The mucosa of the posterior wall was sutured with the remaining part of the anterior wall. The AHI and LaSO<sub>2</sub> were measured both before and six months after the operation by Polysomnography (PSG). Results: This study reported a significant improvement (p ± s) was 48.6 ± 12.65, and LSaO<sub>2</sub> (± s) was 67.4% ± 9.18%;postoperative AHI was 10.9 ± 9.29, and postoperative LSaO<sub>2</sub> was 91.0 ± 1.47. The mean operation duration was 30.1 minutes. Conclusion: The use of HS in UPPP is efficient and shows some advantages over conventional method: its use provided a blood free surgery field, and shorter operation duration.
文摘Purpose: To evaluate the application of a high-frequency electrosurgical scalpel and methylene blue staining in the endonasal dacryocystorhinostomy.Methods: This retrospective study included 37 patients(43eyes).undergoing endonasal dacryocystorhinostomy in our hospital between 2011 and 2013 using methylene blue staining of the lacrimal sac and a high-frequency electrosurgical scalpel for cutting nasal mucosa, intraoperative stanch, and fixation of lacrimal sac and nasal mucosal flaps. Surgical efficacy, intraoperative challenges, and corresponding handling methods were evaluated and summarized.Results: Among 43 eyes, 42 were successfully cured(97.7%)and the symptoms in 1 eye were improved(2.3%). Total efficacy rate was 100%. All surgeries were successfully performed. No severe intraoperative complications were observed.Conclusion: A high-frequency electrosurgical scalpel, combined with methylene blue staining of the lacrimal sac, is efficacious for nasal mucosal cutting, intraoperative stanch, and fixation of mucosal flap by cauterization, which significantly alleviates intraoperative complications and enhances surgical success rate. It deserves widespread application in clinical practice.
文摘Objective To investigate the applied value of the ultrasonic scalpel in gynecologic operative laparoscopy. Methods Gynecologic operations were performed using the ultrasonic scalpel under laparoscopy. Operative bleeding and time, perioperative body temperature and hemogram, and tissue damage were observed.Results Forty-two cases of benign gynecologic diseases were treated with the ultrasonic scalpel under laparoscopy. Among them, there were 4 hysterectomies, 9 ovarian cystectomies, 18 salpingotomies, 4 ectopic pregnancies, 3 myomectomies, 3 adhesiolysis and 1 adnexectomy. The amount of operative bleeding, operating time and the tissue injury were related to the type of operation. The minimual operative bleeding amount, operating time, depth of tissue necrosis, tissue injury score and fibrin deposition score were 24.77±4.71ml, 23.39±3.01 min, 0.22±0.10mm, 0.98±0.21 and 0.38±0.26, respectively. The maximal operative bleeding amount, operating time, depth of tissue necrosis, tissue injury score and fibrin deposition score were 166.7±47.18ml, 127.2±16.99 min, 0.35±0.20mm, 1.25±0.20 and 0.81±0.29, respectively. The levels of body temperature, white blood cells and hemoglobin before and after the operations were not statistically different (P>0.05) except for hysterectomy (P<0.05). Conclusion The ultrasonic scalpel can be safely applied for gynecologic operative laparoscopy and should be used widely.
基金financially supported by the National Natural Science Foundation of China(No.52275420)the Natural Science Foundation of Hunan Province of China(No.2022JJ30136)the Natural Science Foundation of Fujian Province of China(No.2021J05108).
文摘The ultrasonic bone scalpel was often used in all kinds of clinical orthopedic surgery as a new type of medical instrument.Based on the working theory of the ultrasonic bone scalpel and combined with the design method of a quarter wavelength transducer and horn,this study proposed an optimization design method for the ultrasonic bone scalpel with a composite horn structure.The structure of the ultrasonic bone scalpel was simplified,and its length was shortened.Finite element analysis,modal analysis,and harmonic response analysis were used to optimize the design of the ultrasonic bone scalpel.The performance of the ultrasonic bone scalpel was explored through impedance analysis,amplitude measurement,temperature measurement,and cutting tests,and the feasibility of the design was verified through torque analysis.The results showed that when the torque force was 4.0 N,the resonance frequency of the ultrasonic bone scalpel was 30,540 Hz,and the maximum amplitude of the ultrasonic bone scalpel could reach 62μm.After spray cooling,the maximum surface temperature of the rear end cover was reduced from 51.8 to 36.3℃,the maximum surface temperature of the composite horn was reduced from 71 to 45.3℃,and the maximum surface temperature of the cutter head was reduced from 101 to 46.1℃,demonstrating a good cooling effect.Under 89 Voltage,the optimal cutting force for cutting chicken leg bones was 0.1 N,the optimal cutting force for cutting pork ribs was 0.3 N,and the cutting process showed tissue selectivity.
基金This work was supported by Guangdong Province Science and Technology Project(No.2011B080701078).
文摘The harmonic scalpel is a hemostatic device primarily designed for use in laparoscopic surgery.During the last few years,many surgeons have begun to use the harmonic scalpel in open surgery.Several papers have cited the benefits of the device compared with conventional knot-tying techniques;however,no evidence showing the advantages of using the harmonic scalpel in complicated abdominal aortic aneurysm(AAA)surgery has been presented.The aim of the present study is to determine the value of the harmonic scalpel in open operation for AAA.A total of 153 patients who underwent open surgery for AAA at the Department of Vascular Surgery of Guangdong General Hospital,China between January 2001 and December 2010,were retrospectively analyzed.Open surgery performed with the harmonic scalpel on 105 patients was compared with open operation using conventional knot-tying techniques on 48 patients.The operative time,intraoperative blood loss,total postoperative drainage fluid volumes,hospital stay,and postoperative complications between the two groups were compared.The harmonic scalpel group was associated with a shorter operation time(113.2±23.6 min vs.232.1±39.2 min,P<0.01)and lower intraoperative blood loss(126.1±96.6 ml vs.592.1±207.2 ml,P<0.01).Postoperative drainage fluid volumes were greater in the conventional surgery group than in the harmonic scalpel group(702.1±192.8 ml vs.198.5±97.4 ml,P<0.01).The hospital stay was shorter for the harmonic scalpel group than for the conventional surgery group(10.7±3.3 d vs.16.5±4.7 d,P<0.05).No differences between the postoperative complications or hospital mortality of the two groups were found.The harmonic scalpel is a safe and minimally invasive tool in open surgery for AAA and is associated with shorter operative time,shorter hospital stay,and lower intraoperative blood loss and postoperative drainage fluid volumes compared with conventional knot-tying techniques.
基金supported by the National"973"Program of China(No.2005CB724302)the National Science Fund for Distinguished Young Scholars from the National Natural Science Foundation of China(No.60588101)+1 种基金the 111 Project from the Ministry of Education of China(B08020)the Shanghai Commission of Science and Technology(No.05DZ22318,05DZ22325,04DZ05114,and 064119540).
文摘The emergent light distribution of a new type of contact laser scalpel is measured in three different states using a light sensor. The relationship between the angle and the light intensity is analyzed. The results show that the strongest light is emitted from two sides and the front of the scalpel. The light from the front mainly plays a role of cutting. The light from two sides contributes to stanch the wound so as to remain a clear visual field during the surgery. It also helps to increase the cutting efficiency.
