V-Loc^TM 180優施西可吸收傷口縫合裝置運用於腹腔鏡子宮肌瘤切除手術的經驗

目的：腹腔鏡手術的優點較傳統開腹手術多，因此很多手術皆改由腹腔鏡手術來完成。腹腔鏡子宮肌瘤切除手術中以子宮體的止血、縫合和修補最為最重要步驟。但腹腔鏡手術須靠細長的器械來縫合及綁線，但用細長器械比用手縫合和綁線來的不精準，因此組織間的接合較差，縫合處及切面止血有時較困難。V-Loc^TM 180可吸收傷口縫合裝置是一種具備自錨固環和單向倒刺技術的裝置，手術醫師可藉此毋需打結的縫合技術，快速穩定地閉合傷口。因此我們將它拿來運用於腹腔鏡子宮肌瘤切除手術的縫合，以期待可減少手術時間、手術出血量、手術併發症及增加子宮復原的狀況。方法：我們收集從2010年1月起至2012年8月止，因子宮肌瘤來到本院忠孝院區接受腹腔鏡子宮肌瘤切除手術62 位病患。採隨機分組：實驗組用V-Loc^TM180可吸收傷口縫合裝置以連續縫合法；對照組則以2-O vicryl間斷性縫合法。其他手術步驟兩組皆相同。結果：兩組病患的基本資料、手術前的血液學檢查及血液生化檢驗均無差異。手術兩組病患手術後平均子宮肌瘤檢體重量並無統計學上的差異。但實驗組的手術平均時間、手術平均出血量及平均血紅素差則明顯小於對照組。手術後陰道超音波檢查發現實驗組的子宮體復原狀況比較好。結論：V-Loc^TM 180可吸收傷口縫合裝置獨有自錨固環與倒刺的組合，與縫合強度等同的傳統縫合相比，手術醫師可藉此毋需打結、快速穩固地閉合任何傷口。V-Loc^TM 180可吸收傷口縫合裝置可在傷口癒合的關鍵階段將傷口邊緣穩固地縫合在一起，吸收基本可在180天內完成。因此，V-Loc^TM 180可吸收傷口縫合裝置比傳統縫線更適合於腹腔鏡子宮肌瘤切除手術時使用。

關鍵字

子宮肌瘤；腹腔鏡子宮肌瘤切除；優施西可吸收傷口縫合裝置

並列摘要

Objectives: Laparoscopic surgery has several advantages over traditional exploratory laparotomy and as a result many surgeons now prefer to use this surgical approach. Hemostatic control, suturing, and renovating leiomyoma are the most important procedures associated with laparoscopic surgery and involve the use of slender instruments when suturing and tieing off. When compared to the normal situation, suturing and tieing off using slender instruments are more imprecise and more difficult. As a result, problems may occur, such as when the joining of tissue is not strong enough and when there are difficulties carrying out stypsis during suturing and cross-cutting. V-Loc 180 is a superior device that is equipped with an efficient barb and welded loop design. This suture invention is able to help the surgeon to close a wound, to stabilized the closure and to tie off rapidly. We applied this device to laparoscopic myomectomy with the aim of diminishing surgery time, reducing blood loss and reducing the number of complication; such improvement ought to result in better uterus recovery. Methods: This prospective study evaluated data on the efficacy of treatment of 62 women who underwent laparoscopic myomectomy at Taipei City Hospital Zhongxiao Branch from January 2010 through to August 2012. The patients were randomly assigned to either the V-Loc^TM 180 group and the 2-0 vicryl suture group. Result: The two groups were similar in terms of age, body weight, delivery number, hemoglobin and hematocrit before surgery. After surgery, blood loss, operation time, change in hemoglobin, change in hematocrit and the presence of uterus defects among the V-Loc^TM 180 group were significant less than among the vicryl group. Conclusion: When compared with traditional suture material, the V-Loc 180 absorbable wound closure device, which is equipped with an efficient barb and welded loop design, allows the surgeon to stably close any wound rapidly without having to tie-off separately. The wound margin is held firmly together, which is especially important during the critical stage of wound heal over; furthermore, the sutures are absorbable in 180 days. In conclusion, the V-Loc 180 brings a lot of benefits when used for laparoscopic myomectomy.

並列關鍵字

leiomyoma ； laparoscopic myomectomy ； V-Loc 180

國際替代計量

V-Loc^TM 180優施西可吸收傷口縫合裝置運用於腹腔鏡子宮肌瘤切除手術的經驗

全文下載

主題瀏覽