APPLICATIONS OF THE LAPAROSCOPIC ULTRASONIC ASPIRATOR FOR ADVANCED GYNECOLOGIC OPERATIVE ENDOSCOPIC PROCEDURES

We evaluated the efficacy of a new laparoscopic ultrasonic aspirator a nd applied it in gynecologic endoscopy. Two procedures were selected f or preliminary evaluation of the instrument: ultrasonic aspiration for selective presacral neurectomies and total laparoscopic hysterectomy (TLH). The aspirator worked successfully in evacuating soft tissue and in adequately exposing the presacral plexus. In TLH we were able to s keletonize the broad ligament adventitia all the way to the level of t he uterine arteries bilaterally, including exposure of the ureters. Th e time required for the procedures varied from case to case, and stron gly depended on tissue type and on instruments used to dissect and imp rove visualization of the operative field. The aspirator may prove use ful as an adjunctive in the surgical management of endometriosis, in l aparoscopic lymphadenectomy, and in treating complex adhesions after f urther evaluation is completed.