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Efficiency and Reliability of Using the Harmonic™ Scalpel Power Supply in Simple Cyst Decortication: A State Hospital Experience

Yıl 2012, Cilt: 3 Sayı: 12, 1 - 8, 03.03.2015

Öz

Aim: In literarture, monopolar cutting forceps,
plasmacinetic cutting forceps and argon laser
were routinely using for laporoscopic renal
simple cyst decortication. Our study aim was
to determine the efficacy and safety of the use
of Harmonic scalpel energy source in simple
renal cyst laparoscopic decortication.
Material and methods: In our clinic, 7
patients underwent operated laparoscopic renal
cyst excision with transperitoneal approach
between January 2006 and February 2010.
Pneumoperitoneum was created by entering
the peritoneum. After opening line Todd and
Gerota cyst has been reached. Cyst wall was
decorticated using by Harmonic ™ scalpel.
After placement of silicone drain operation
was terminated.
Results: The mean age of patients was 59 (22-
83), 5 patients were male and 2 were female.
Cysts were located 4 in the right, 3 in the left
kidney. Average cyst diameter was 96.1 mm
(83-110). The mean operation time was 96 ±
8.7 minutes. The mean drain time was 1,8±1,2
days. Average hospital stay time was 2.5 ± 1.7
days. Mean follow-up time was 13.4 (9-19)
months. Symptomatic recurrence was observed
in any patient. In one of the patients had
radiological recurrence.
Conclusion: Harmonic scalpel ™ is an
effective and safe device of laparoscopic renal
cyst decortication that can be used.

Kaynakça

  • Siegel CL, McFarland EG, Brink JA, Fisher AJ, Humphrey P, Heiken JP (1997) CT of
  • cystic renal masses: analysis of diagnostic performance and interobserver variation. AJR Am
  • J Roentgenol 169 (3):813-818. doi:10.2214/ajr.169.3.9275902
  • Amar AD, Das S (1984) Surgical management of benign renal cysts causing obstruction of
  • renal pelvis. Urology 24 (5):429-433
  • Moufid K, Joual A, Debbagh A, el Mrini M (2002) (Lumboscopic treatment of simple renal
  • cysts: initial experience with 17 cases). Prog Urol 12 (6):1204-1208
  • Atug F, Burgess SV, Ruiz-Deya G, Mendes-Torres F, Castle EP, Thomas R (2006) Longterm
  • durability of laparoscopic decortication of symptomatic renal cysts. Urology 68 (2):272-
  • doi:10.1016/j.urology.2006.03.009
  • Hulbert JC (1992) Laparoscopic management of renal cystic disease. Semin Urol 10
  • (4):239-241
  • Tefekli A, Altunrende F, Baykal M, Sarilar O, Kabay S, Muslumanoglu AY (2006)
  • Retroperitoneal laparoscopic decortication of simple renal cysts using the bipolar
  • PlasmaKinetic scissors. Int J Urol 13 (4):331-336. doi:10.1111/j.1442-2042.2006.01299.x
  • Tuncel A, Aydin O, Balci M, Aslan Y, Atan A (2011) Laparoscopic decortication of
  • symptomatic simple renal cyst using conventional monopolar device. Kaohsiung J Med Sci 27
  • (2):64-67. doi:10.1016/j.kjms.2010.09.002
  • Laucks SP, Jr., McLachlan MS (1981) Aging and simple cysts of the kidney. Br J Radiol
  • (637):12-14
  • İstanbulluoğlu MO, Koşan, Murat, Çiçek, Tufan, Öztürk, Bülent, Özkardeş, Hakan. (2010)
  • Böbrek Kistlerinin Laparoskopik Dekortikasyonunda Ultrasonik Enerji Kullanımı: Etkin ve
  • Güvenilir Bir Yöntem. Selçuk Ünv Tıp Derg 26 (4):3
  • Wolf JS, Jr. (1998) Evaluation and management of solid and cystic renal masses. J Urol
  • (4):1120-1133
  • Demir E, Alan C, Kilciler M, Bedir S (2007) Comparison of ethanol and sodium
  • tetradecyl sulfate in the sclerotherapy of renal cyst. J Endourol 21 (8):903-905.
  • doi:10.1089/end.2006.0462
  • Kilinc M, Tufan O, Guven S, Odev K, Gurbuz R (2008) Percutaneous injection
  • sclerotherapy with tetracycline hydrochloride in simple renal cysts. Int Urol Nephrol 40
  • (3):609-613. doi:10.1007/s11255-007-9316-5
  • Madeb R, Feldman PA, Knopf J, Rub R, Erturk E, Yachia D (2006) Povidone-iodine
  • sclerotherapy is ineffective in the treatment of symptomatic renal cysts. J Endourol 20
  • (6):402-404. doi:10.1089/end.2006.20.402
  • Okeke AA, Mitchelmorre AE, Timoney AG (2001) Comparison of single and multiple
  • sessions of percutaneous sclerotherapy of simple renal cysts. BJU Int 87 (3):280
  • Okeke AA, Mitchelmore AE, Keeley FX, Timoney AG (2003) A comparison of aspiration
  • and sclerotherapy with laparoscopic de-roofing in the management of symptomatic simple
  • renal cysts. BJU Int 92 (6):610-613
  • Meyer F, Ioshii SO, Chin EW, Esser DM, Marcondes RT, Patriani AH, Pimpao Bde F
  • (2007) Laparoscopic partial nephrectomy in rats. Acta Cir Bras 22 (2):152-156
  • Yıldırım A BE, Göçer S, Başaran A, Tokuç R. (2009) Laparoskopik bipolar ve ultrasonik
  • enerji aletlerinin kullanımındaki termal yayılımın değerlendirilmesi. Türk Üroloji Dergisi 35
  • (3):5
  • Thwaini A, Shergill IS, Arya M, Budair Z (2007) Long-term follow-up after
  • retroperitoneal laparoscopic decortication of symptomatic renal cysts. Urol Int 79 (4):352-
  • doi:10.1159/000109722
  • Shiraishi K, Eguchi S, Mohri J, Kamiryo Y (2006) Laparoscopic decortication of
  • symptomatic simple renal cysts: 10-year experience from one institution. BJU Int 98 (2):405-
  • doi:10.1111/j.1464-410X.2006.06249.x
  • Su L (2006) Laparoskopic renal cyst ablation: Technique and results. Texbook of
  • laparoscopic urology. Taylor&Francis Ltd, New York

BASİT BÖBREK KİSTİ LAPAROSKOPİK DEKORTİKASYONUNDA HARMONİC™ SKALPEL ENERJİ KAYNAĞI KULLANIMININ ETKİNLİĞİ VE GÜVENİLİRLİĞİ: DEVLET HASTANESİ TECRÜBESİ

Yıl 2012, Cilt: 3 Sayı: 12, 1 - 8, 03.03.2015

Öz

Amaç: Basit böbrek kisti dekortikasyonunda
monopolar kesici, plasmakinetik kesici ve
argon lazer uygulamaları literatürde yer
almaktadır. Bu çalışmamızda amacımız basit
böbrek kistinin laparoskopik
dekortikasyonunda Harmonic™ Scalpel enerji
kaynağının kullanımının etkinlik ve
güvenilirliğinin belirlenmesidir.

Gereç ve yöntem: Kliniğimizde Mart 2010 ve
Ocak 2011 yılları arasında toplam 7 hastaya
böbrek kisti nedeniyle transperitoneal
laparoskopik kist dekortikasyonu
uygulanmıştır. Peritona girilerek
pnömoperitoneum oluşturuldu. Todd çizgisi ve
gerato açıldıktan sonra kiste ulaşıldı. Kist
duvarı Harmonic™ scalpel kullanılarak
dekortike edildi. Operasyon lojuna silikon dren
konularak operasyon sonlandırıldı.

Bulgular: Hastaların ortalama yaşları 59 (22-
83) olarak bulundu, 5 hasta erkek 2 hasta kadın
idi. Kistlerin 4 tanesi sağ, 3 tanesi sol böbrek
yerleşimli idi. Kist çapları ortalama 96,1 mm
(83-110) idi. Ortalama operasyon süresi
96±8,7 dakika idi. Tüm hastaların loj drenleri
1,8±1,2 gün kaldı. Ortalama yatış süresi
2,5±1,7 gün olarak bulundu. Ortalama takip
süresi ise 13,4 (9-19)ay olarak bulundu. Hiçbir
hastada semptomatik rekürrens gözlenmedi.
Radyolojik rekürrens ise 1 hastada görüldü.

Sonuç: Harmonic™ scalpel laparoskopik
böbrek kisti dekortikasyonunda güvenle
kullanılabilecek etkin bir yöntemdir.

Kaynakça

  • Siegel CL, McFarland EG, Brink JA, Fisher AJ, Humphrey P, Heiken JP (1997) CT of
  • cystic renal masses: analysis of diagnostic performance and interobserver variation. AJR Am
  • J Roentgenol 169 (3):813-818. doi:10.2214/ajr.169.3.9275902
  • Amar AD, Das S (1984) Surgical management of benign renal cysts causing obstruction of
  • renal pelvis. Urology 24 (5):429-433
  • Moufid K, Joual A, Debbagh A, el Mrini M (2002) (Lumboscopic treatment of simple renal
  • cysts: initial experience with 17 cases). Prog Urol 12 (6):1204-1208
  • Atug F, Burgess SV, Ruiz-Deya G, Mendes-Torres F, Castle EP, Thomas R (2006) Longterm
  • durability of laparoscopic decortication of symptomatic renal cysts. Urology 68 (2):272-
  • doi:10.1016/j.urology.2006.03.009
  • Hulbert JC (1992) Laparoscopic management of renal cystic disease. Semin Urol 10
  • (4):239-241
  • Tefekli A, Altunrende F, Baykal M, Sarilar O, Kabay S, Muslumanoglu AY (2006)
  • Retroperitoneal laparoscopic decortication of simple renal cysts using the bipolar
  • PlasmaKinetic scissors. Int J Urol 13 (4):331-336. doi:10.1111/j.1442-2042.2006.01299.x
  • Tuncel A, Aydin O, Balci M, Aslan Y, Atan A (2011) Laparoscopic decortication of
  • symptomatic simple renal cyst using conventional monopolar device. Kaohsiung J Med Sci 27
  • (2):64-67. doi:10.1016/j.kjms.2010.09.002
  • Laucks SP, Jr., McLachlan MS (1981) Aging and simple cysts of the kidney. Br J Radiol
  • (637):12-14
  • İstanbulluoğlu MO, Koşan, Murat, Çiçek, Tufan, Öztürk, Bülent, Özkardeş, Hakan. (2010)
  • Böbrek Kistlerinin Laparoskopik Dekortikasyonunda Ultrasonik Enerji Kullanımı: Etkin ve
  • Güvenilir Bir Yöntem. Selçuk Ünv Tıp Derg 26 (4):3
  • Wolf JS, Jr. (1998) Evaluation and management of solid and cystic renal masses. J Urol
  • (4):1120-1133
  • Demir E, Alan C, Kilciler M, Bedir S (2007) Comparison of ethanol and sodium
  • tetradecyl sulfate in the sclerotherapy of renal cyst. J Endourol 21 (8):903-905.
  • doi:10.1089/end.2006.0462
  • Kilinc M, Tufan O, Guven S, Odev K, Gurbuz R (2008) Percutaneous injection
  • sclerotherapy with tetracycline hydrochloride in simple renal cysts. Int Urol Nephrol 40
  • (3):609-613. doi:10.1007/s11255-007-9316-5
  • Madeb R, Feldman PA, Knopf J, Rub R, Erturk E, Yachia D (2006) Povidone-iodine
  • sclerotherapy is ineffective in the treatment of symptomatic renal cysts. J Endourol 20
  • (6):402-404. doi:10.1089/end.2006.20.402
  • Okeke AA, Mitchelmorre AE, Timoney AG (2001) Comparison of single and multiple
  • sessions of percutaneous sclerotherapy of simple renal cysts. BJU Int 87 (3):280
  • Okeke AA, Mitchelmore AE, Keeley FX, Timoney AG (2003) A comparison of aspiration
  • and sclerotherapy with laparoscopic de-roofing in the management of symptomatic simple
  • renal cysts. BJU Int 92 (6):610-613
  • Meyer F, Ioshii SO, Chin EW, Esser DM, Marcondes RT, Patriani AH, Pimpao Bde F
  • (2007) Laparoscopic partial nephrectomy in rats. Acta Cir Bras 22 (2):152-156
  • Yıldırım A BE, Göçer S, Başaran A, Tokuç R. (2009) Laparoskopik bipolar ve ultrasonik
  • enerji aletlerinin kullanımındaki termal yayılımın değerlendirilmesi. Türk Üroloji Dergisi 35
  • (3):5
  • Thwaini A, Shergill IS, Arya M, Budair Z (2007) Long-term follow-up after
  • retroperitoneal laparoscopic decortication of symptomatic renal cysts. Urol Int 79 (4):352-
  • doi:10.1159/000109722
  • Shiraishi K, Eguchi S, Mohri J, Kamiryo Y (2006) Laparoscopic decortication of
  • symptomatic simple renal cysts: 10-year experience from one institution. BJU Int 98 (2):405-
  • doi:10.1111/j.1464-410X.2006.06249.x
  • Su L (2006) Laparoskopic renal cyst ablation: Technique and results. Texbook of
  • laparoscopic urology. Taylor&Francis Ltd, New York
Toplam 52 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Sağlık Kurumları Yönetimi
Bölüm Original Articles
Yazarlar

M. Rifaioğlu Bu kişi benim

Kadir Önem Bu kişi benim

Özkan Göğebakan Bu kişi benim

Yayımlanma Tarihi 3 Mart 2015
Gönderilme Tarihi 1 Mart 2015
Yayımlandığı Sayı Yıl 2012 Cilt: 3 Sayı: 12

Kaynak Göster

Vancouver Rifaioğlu M, Önem K, Göğebakan Ö. BASİT BÖBREK KİSTİ LAPAROSKOPİK DEKORTİKASYONUNDA HARMONİC™ SKALPEL ENERJİ KAYNAĞI KULLANIMININ ETKİNLİĞİ VE GÜVENİLİRLİĞİ: DEVLET HASTANESİ TECRÜBESİ. mkutfd. 2015;3(12):1-8.