Reconsideration of Sharp Dissection in Gynecological Surgery.

IF 1.4 Q3 OBSTETRICS & GYNECOLOGY Gynecology and Minimally Invasive Therapy-GMIT Pub Date : 2023-04-01 DOI:10.4103/gmit.gmit_3_23
Yasuhito Tanase, Muneaki Shimada, Mayumi Kobayashi Kato, Masaya Uno, Mitsuya Ishikawa, Tomoyasu Kato
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Abstract

In surgical fields, sharp dissection is a basic surgical technique, and the prognosis and oncological outcomes are known to be affected by the technique of dissection. Even in gynecologic surgery, we believe that the basic surgical technique is sharp dissection. We herein present our technique and discuss its significance. Sharp dissection should entail the removal of a single thin line between the residual tissue and the excised tissue. If this line becomes multiple or thicker, it is not sharp dissection but blunt dissection. The accumulation of this thin line of sharp dissection can form surgical layers. What is important is moderate tissue tension and how to use monopolar. One can sharply cut the loose connective tissue assisted by moderate tissue tension. With regard to the use of monopolar, it is essential that it not be applied directly to the tissue, but rather be used with or without touching the tissue. Inadvertent blunt dissection should be minimized, as most surgical procedures can be performed with sharp dissection. We usually perform sharp dissection for open surgery as well as minimally invasive surgery. We obstetricians and gynecologists should reconsider the significance of sharp dissection and practice it in gynecological surgery.

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妇科手术中尖锐解剖的再思考。
在外科领域,尖锐解剖是一项基本的手术技术,其预后和肿瘤预后都受到解剖技术的影响。即使在妇科手术中,我们认为基本的手术技术是尖锐的解剖。我们在此介绍我们的技术并讨论其意义。尖锐的解剖需要去除残留组织和切除组织之间的一条细线。如果这条线变多或变粗,则不是尖锐解剖而是钝性解剖。这种尖锐剥离的细线的积累可以形成手术层。重要的是适度的组织张力和如何使用单极子。在适度组织张力的辅助下,可以迅速切断松散的结缔组织。关于单极子的使用,重要的是它不能直接应用于组织,而是与或不接触组织一起使用。应尽量减少无意的钝性剥离,因为大多数外科手术都可以进行尖锐剥离。我们通常在开放手术和微创手术中进行尖锐解剖。我们的妇产科医生应该重新思考尖锐解剖的意义,并在妇科手术中加以应用。
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来源期刊
CiteScore
2.00
自引率
16.70%
发文量
98
审稿时长
52 weeks
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