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PubMedDate not supplied

An introduction to the principles and safety of electrosurgery.

With the advent of minimal access surgery, the use of different energy sources has made a tremendous contribution to the treatment modalities in many gynaecological disorders. The trainee must be clear in the understanding of not only the application of energy sources, but also the principles behind their use. This article has thus been written to provide insight into avoiding patient injury as well as safety of use.

Electrocoagulation↗
PubMedDate not supplied

[The use of new technologies in the endoscopic electrosurgery of benign prostatic hyperplasia of large dimensions].

The technique of electrovaporization, a novel low-traumatic method, has been practiced in the Research Institute of Urology (Moscow) for the treatment of benign prostatic hyperplasia (BPH) since 1995. This technique is based on the standard transurethral resection (TUR) being superior in the absence of intraoperative bleeding. Its application, however, is restricted to hyperplasia of small and moderate size. But TUR, in its turn, provides more rapid removal of the tissue. These advantages of the two techniques were combined in the treatment of extensive BPH. Compared to TUR, standard TUR combination with electrovaporization proved much more effective. Progressive techniques in endoscopic surgery comprise also use of novel resection electrodes which differ from the previous analogues by thickness, shape and coating. When used in electroresection, such electrodes provide simultaneous removal of the tissue, electrovaporization and coagulation of the underlying tissues. The above technical innovations allowed advance in the quality of endoscopic interventions, widening indications for endoscopic electrosurgical management of large-size BPH and decreasing the incidence of relevant complications.

Aged↗
PubMed1998

[Arthroscopic shoulder stabilization. Differentiated treatment strategy with Suretac, Fastak, Holmium: YAG-laser and electrosurgery].

The goal for arthroscopic stabilization of anterior glenohumeral instability is to achieve an outcome equivalent to or better than open procedures. A number of arthroscopic procedures have been advocated to reestablish continuity of the inferior glenohumeral ligament complex (IGHLC) with the glenoid. Implantable suture anchors were developed to avoid the problems associated with arthroscopic staple capsulorrhaphy like iatrogenic injury of the glenoid or humeral surface, loosening and migration of the staple. Several transosseous techniques include the need for an accessory posterior incision, the possibility of neurovascular injury (Suprascapular or axillary nerve), and the loosening of the repair after typing over the fascia of the infraspinatus posteriorly. The preferred techniques are cannulated, absorbable fixation device (Suretac) and easy implantable suture anchors made of titanium (Fastak). Even in the hands of experienced arthroscopists, unacceptably high recurrence rates for arthroscopic shoulder stabilization have been reported, due to the steep learning curve for both technical performance and patient selection. Our experience suggests, that if proper selection criteria are employed, normal patients and overhead-athletes may benefit from the advantages of an arthroscopic repair without accepting an increased risk for recurrence. We performed a prospective analysis of 105 shoulders, who underwent arthroscopic stabilization with Suretac or Fastak between 4/96 and 7/98. 48 shoulders were available for followup at least one year. The redislocation rate was 6.25% (3 shoulders) and the rate of subluxation without dislocation also was 6.25%, but none of the shoulders required a second open stabilization. The reason for redislocation or subluxation were 5/6 traumatic injuries, participating in contact sports or in one case a generalized ligamentous laxity. In combination with the LACS-Procedure or the Electro thermally assisted capsular shift (ETACS) not only the capsular detachment but also the capsular redundancy may be adressed and a lower failure rate can be expected.

Arthroscopy↗