Regular Contributions
Conization of the Cervix Using
Harmonic Scalpel
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RYO KONNO, JUN-ICHI AKAHIRA, TSUKASA IGARASHI, HIROMITSU YAMAKAWA, SHINJI SATO and AKIRA YAJIMA
- Department of Obstetrics and Gynecology,
Tohoku University School of Medicine, Sendai 980-8574
Conization, as a surgical
treatment for cervical intraepithelial neoplasm (CIN), is a good
method that preserves reproductive functions. Technological
developments have introduced a wide variety of energy sources for
surgical procedures. Traditional cold knife conization has been
replaced by laser conization and by the loop electrosurgical
excisional procedure (LEEP). However, laser conization and LEEP have
some disadvantages. Laser conization requires expensive equipment.
LEEP induces electrocautery artifacts and cannot excise the cervical
tissue as a single-piece, because of the various extensions and
depths of lesion, so that evaluation of the margins is sometimes not
possible. Laser conization and LEEP both generate smoke. The presence
of smoke is not only inconvenient, but also dangerous. Harmonic
Scalpel (HS), ultrasonic cutting and coagulation system, is a new
surgical tool that cuts and coagulates using ultrasonic mechanical
vibrations. Eleven women with CIN III underwent conization using HS.
HS eliminated the major disadvantages of electrosurgery and laser
surgery. No complications during conization were observed.
Postoperative hemorrhage was noted in only one patient. Histological
diagnosis was not affected by heat or ultrasound. This surgical
method using HS is characterized by negligible bleeding, a good
visual field not obscured by smoke and resection of an ideal shape
that fits the size of the lesion. It is concluded that this method
overcomes most problems associated with conization using conventional
methods.
Key words--- conization; cervical
intraepithelial neoplasia; Harmonic Scalpel; surgical
procedure
© 1999 Tohoku University Medical Press
Tohoku J. Exp. Med., 1999,
189,171-178
Address for reprints: Ryo Konno, M.D., Department of
Obstetrics and Gynecology, Tohoku University School of Medicine, 1-1
Seiryomachi, Aoba-ku, Sendai 980-8574, Japan.
e-mail: konno@ob-gy.med.tohoku.ac.jp
Harmonic Scalpel is a registrated trademark of Ethicon Endo-Surgery,
Incorporated.
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