Laparoscopic Monopolar Scissors: Basic Laparoscopic Tool
In laparoscopic surgery, the laparoscopic monopolar scissors is an important tool that achieves precise tissue dissection through high-frequency current technology. This article will detail the basic principles, operation methods, and techniques of the laparoscopic monopolar scissors to help improve the efficiency and safety of surgery.
Basic Principles of High-Frequency Laparoscopic Monopolar Scissors
Laparoscopic monopolar scissors operate based on the basic principle of high-frequency electrosurgical units. These units use the thermal effect generated when current passes through biological tissue for tissue cauterization and dissection. Typically set at a frequency of 300KHz, they can effectively cut and coagulate tissue. Laparoscopic monopolar scissors concentrate the current at the tip of the blade, allowing for focused heating and rapid temperature rise, thereby achieving precise tissue dissection. Conversely, dispersed current reduces heating and slows temperature rise, which enables the laparoscopic monopolar scissors to minimize damage to surrounding tissues during delicate operations.
Operation Steps and Techniques of Laparoscopic Monopolar Scissors
How to Use Monopolar Electrosurgical Units
When using the laparoscopic monopolar scissors, follow these steps to ensure safety and effectiveness:
Device Preparation
Ensure that the laparoscopic monopolar scissors are correctly connected and place the foot pedal in a suitable position. Coordinate the use of hands, feet, and eyes, especially keeping the hands stable.
Operation Steps
Gently place the laparoscopic monopolar scissors on the target tissue and press the foot pedal to activate the current for dissection.
After dissection, release the foot pedal first and then remove the laparoscopic monopolar scissors.
Avoid prolonged activation of the foot pedal to prevent excessive smoke, which can obscure the field of vision.
Precautions for the Use of the Neutral Electrode Plate
Avoid placing the neutral electrode plate on bony prominences, joints, or areas of dry skin to prevent burn injuries due to poor current return.
Ensure good contact between the neutral electrode plate and the skin, avoiding areas under pressure or those with heat concentration.
Operational Techniques
Mastering the techniques for using the laparoscopic monopolar scissors can significantly improve the precision of the surgery:
Power Setting: Adjust the power of the electrosurgical unit to the minimum value necessary to complete the operation, typically 40-60 watts, to avoid excessive thermal damage.
Tissue Retraction: Use curved dissecting forceps to lift the tissue, creating tension for the laparoscopic monopolar scissors to dissect along tissue planes. This helps in clearly defining anatomical layers and ensuring operational precision.
Distance Control: Maintain a small distance between the laparoscopic monopolar scissors and the tissue to generate uniform small sparks for pulsed activation, avoiding excessive pressing that could cause additional damage.
Wandering Speed: Control the wandering speed of the laparoscopic monopolar scissors. Moving too slowly can cause eschars, while moving too quickly may damage other important tissues.
Neutral Electrode Plate Contact: Ensure good contact between the neutral electrode plate and the skin with as large a contact area as possible to prevent burns due to high resistance.
Common Mistakes and How to Avoid Them When Using Laparoscopic Monopolar Scissors
Common mistakes when using the laparoscopic monopolar scissors include:
Electrosurgical Unit Not in Contact with Target Tissue
Ensure that the laparoscopic monopolar scissors make contact with the target tissue with each activation, to avoid damaging surrounding tissues.
Prolonged Activation
Avoid prolonged activation to prevent tissue eschar formation.
High Temperature
After activation, avoid letting the laparoscopic monopolar scissors touch other tissues to prevent further thermal injury.
Poor Hand Coordination
Ensure good coordination between both hands to create the appropriate tension for better tissue separation.
