ligasuretm的临床应用课件

LigaSureTM

的临床应用EnergyBasedTissueandVesselFusionVesselandTissueLigation

Whatareyourchoices?LigationTechniquesManufacturer'sRecommendedRangeofVesselSizeforApplication(mm)0.51.01.52.02.53.03.54.04.55.05.56.06.57.07.58.08.59.09.510.0Suture

Clips

Staples

MonopolarES

BipolarES

UltrasonicCoag

VesselSealing

**3sizesofclipsandappliersVascularStaples

ElectrosurgicalTechnologyThatCombinesPressureandEnergy压力和能量ToCreateaFusionZone产生一个融合带TissueandVesselFusionVesselFusionSystem

脉管闭合系统SystemOperationAppliesoptimalpressuretovessel/tissuebundle在血管/组织束上施加最正确的压力Energydeliverycycle:能量输送周期：Measuresinitialresistanceoftissueandchoosesappropriateenergysettings测量组织的最初电阻并选择适当的能量设定Deliverspulsedenergywithcontinuousfeedbackcontrol输送能量脉冲同时进行持续的反响控制Pulsesadaptasthecycleprogresses随循环周期的进行调整能量脉冲Sensesthattissueresponseiscompleteandstopsthecycle监测组织反响当闭合完成时停止能量输送FusionCharacteristics

融合带的特性Intimallayersofvesselwallsfused融合血管壁的内膜Doesnotrelyonaproximalthrombus不依赖于近端血栓Permanent永久性闭合Coagulationreliesonvesselshrinkageandaproximalthrombusforvesselocclusion.凝血依赖于血管的收缩和近端血栓堵塞血管*PorcineModelFusionCharacteristicsPlastic-likeconsistency

duetocollagenremodeling由于胶原蛋白的重塑，闭合带均一而且富有弹性。Distinctive,possibly

translucentfusionzone独特的透明闭合带Withstandsgreaterthanthreetimesnormalsystolicpressure可承受3倍以上的正常收缩压TissueSelectionCriteria

选择组织的标准Veinsandarteriesuptoandincluding7mm到达并包括7mm的静脉和动脉Tissuebundlescontainingvessel(s)orlymphatics包含有血管或淋巴管的组织束Lymphaticsuptoandincluding7mm到达并包括7mm的淋巴管ResultsHighburststrengthsealsexhibitedthefollowingproperties:高破裂压的闭合带具有以下特性：Thin,translucent,plastic-likesealsite薄的透明弹性闭合带sealzonesignificantlycompressed被压缩的扁平闭合带intimallayersofvesselwallsfused融合血管壁内膜lateralthermaldamage<2mm外侧热损伤<2mmH&EstainedlongitudinalsectionofsealedporcinerenalarteryH&E染色的猪肾动脉闭合带的纵切面Thesealzone.Notethefusedlumenofthevesselwalls.闭合带；注意血管壁已被融合在一起，内腔消失。BurstStrengthStudyResults

Percentsuccessoffusionzonewithstanding3timesnormalsystolicpressure(360mmHg)0%20%40%60%80%100%1.0-1.9mm

2-3.9mm4-7mmUltrasonics超声刀Bipolar双极VesselFusion脉管闭合技术VesselsizesComparisonStudyResultsHealingprocess

*ComparisonofHealingProcessFollowingLigationwithSuturesandBipolarVesselSealingPETERSON,STRANAHAN,SCHMALTZ,MIHAICHUK,COSGRIFFSurgicalTechnologyInternationalSuturesat28daysLigaSureat28daysVesselFusionTechnologyVesselFusionTechnologyEnsures:Reliable,consistent,permanentvesselwallfusion可靠的、一致的、永久性血管壁融合Minimalthermalspread最小的热传导Reducedstickingandcharring较少的粘连和焦痂SurgicalspecialtieswithexperienceinvesselfusiontechnologySurgicalApplicationsLigaSureTMClinicalApplicationsGeneralSurgeryGynaecology

妇产科Studyby:BarbaraLevy,MD

ClinicalAssistantProfessorof

OB/GYN,UofWASeattle,WASealableNotrecommendedStudyby:RobertMcLellan,MDDepartmentofGynecologyLaheyClinic,Burlington,MATotalAbdominalHysterectomySealableNotrecommended结肠解剖ColonAnatomy结肠的解剖LowAnteriorResection低位前切除IndicationsColoncarcinoma结肠癌Rectosigmoidcancers直乙结肠癌 Rectalcancer直肠癌Benigncolonpolyps良性结肠息肉Diverticulitis憩室Volvulus肠扭转Crohn'sdiseaseofthebowel克隆氏病Squamouscellcarcinomaoftheanus肛管鳞状上皮细胞癌Analorrectalsarcomas肛门或直肠肉瘤Crohn'sdiseaseoftherectum直肠克隆氏病Analorrectalmelanoma肛门或直肠黑色素瘤LaparoscopicSurgeryLesspain较少的疼痛Fasterrecovery更快的恢复