Hystérectomie sans douleur - Dr H.Clavé
http://www.clave-henri.com
Painless vaginal hysterectomy with thermal haemostasis and multimodal anesthesia : The new paradigm for Hysterectomy ?
Study objective : To report an innovative surgical procedure for vaginal hysterectomy to fight pains and obtain a fast post-operative recovery.
Design : The classical technic of vaginal hysterectomy is simplified using thermal haemostasis with ERBE Bi-Clamp® and multimodal anesthesia.
Setting: Clinique St George Nice (France)
Patients: Between march 2002 and july 2004, 152 patients presenting with benign lesions had been operated based on this innovative surgical technique.
Interventions: This video describe with precisions each steps of the technique, and detailed the specific issues allowing a very low rate of adverse events. The multimodal anesthetic procedure is detailed to avoid nociceptive effects. The haemostasis with high-frequency current and modulated impulses depending of the impedance is made with the ERBE Bi-Clamp®. This tool with easy handling makes easier and faster difficult haemostasis particularly through narrow vagina or for infundibulo-pelvic ligaments. The branches are covered with a wide and smooth steel surface which reduce sticking effect and thereby the risk of carbonisation. There were only 2 instruments in the vagina: The Pozzi forceps for the positioning of the treated area, and alternately the Bi-Clamp® or the scissors. The Bi-Clamp® should always carried out as close as possible to the middle of the vaginal shaft at the edge of the uterus.
Results: No serious immediate or secondary bleeding, no thermal trauma to the ureter or to the intestines was noted and no fistula developed. One randomized sub-group demonstrated a substantial reduction of pain. For the last 50 patients a standard hospital stay of one day was possible in 86% of cases. Conclusion: This easier and faster innovative procedure for vaginal hysterectomy expand the range of vaginal indications while shortening the patient’s stay to one day.
Painless vaginal hysterectomy with thermal haemostasis and multimodal anesthesia : The new paradigm for Hysterectomy ?
Study objective : To report an innovative surgical procedure for vaginal hysterectomy to fight pains and obtain a fast post-operative recovery.
Design : The classical technic of vaginal hysterectomy is simplified using thermal haemostasis with ERBE Bi-Clamp® and multimodal anesthesia.
Setting: Clinique St George Nice (France)
Patients: Between march 2002 and july 2004, 152 patients presenting with benign lesions had been operated based on this innovative surgical technique.
Interventions: This video describe with precisions each steps of the technique, and detailed the specific issues allowing a very low rate of adverse events. The multimodal anesthetic procedure is detailed to avoid nociceptive effects. The haemostasis with high-frequency current and modulated impulses depending of the impedance is made with the ERBE Bi-Clamp®. This tool with easy handling makes easier and faster difficult haemostasis particularly through narrow vagina or for infundibulo-pelvic ligaments. The branches are covered with a wide and smooth steel surface which reduce sticking effect and thereby the risk of carbonisation. There were only 2 instruments in the vagina: The Pozzi forceps for the positioning of the treated area, and alternately the Bi-Clamp® or the scissors. The Bi-Clamp® should always carried out as close as possible to the middle of the vaginal shaft at the edge of the uterus.
Results: No serious immediate or secondary bleeding, no thermal trauma to the ureter or to the intestines was noted and no fistula developed. One randomized sub-group demonstrated a substantial reduction of pain. For the last 50 patients a standard hospital stay of one day was possible in 86% of cases. Conclusion: This easier and faster innovative procedure for vaginal hysterectomy expand the range of vaginal indications while shortening the patient’s stay to one day.
09-08-2008
