LAPAROSCOPIC PARAAORTIC LYMPHADENECTOMY USING LAPAROSONIC COAGULATINGSHEARS

With marked innovations in endosurgical instrumentation, operative lap aroscopy to include lymphadenectomy has become feasible and has a valu able role in the management of gynecologic malignancy. We used laparos onic coagulating shears (LCS) for laparoscopic paraaortic lymphadenect omy in two women with cervical carcinoma. Operating times for the lapa roscopic portion were 55 and 65 minutes and blood loss was 20 and 30 m i, respectively. No surgical complications were encountered Lymphatic tissues were evaluated histologically and no ther mal artifacts were i dentified. The major advantage oi the ultrasonically activated scalpel of the LCS is the ability to cut and coagulate tissues simultaneously without electrical current. The LCS may afford the surgeon a greater mar gin of safety than unipolar electrocoagulation scissors by elimina ting potential thermal and electrical injury to vital structures. Ultr asonic-activated technology deserves extended clinical investigation i n laparoscopic lymphadenectomy to substantiate our preliminary finding s, as well as to explore its potential in gynecologic oncology.