VOLUME 31 - NUMBER 4 - 2010

Ultrasound scissors versus electrocautery in axillary dissection: our experience


  • Sanguinetti A., Docimo G., Ragusa M., Calzolari F., D'Ajello F., Ruggiero R., Parmeggiani D., Pezzolla A., Procaccini E., Avenia N.
  • Articolo Originale, 151-153
  • Full text PDF

  • Versione Italiana: Le forbici ad ultrasuoni da qualche tempo vengono impiegate come strumento chirurgico per dissezione ed emostasi. Fino ad ora impiegate nella chirurga minimamente invasiva, ne abbiamo testato efficacia ed utilità nella dissezione ascellare, paragonando i dati emersi dal loro utilizzo in 35 cancri della mammella con 35 casi controllo nei quali è stato impiegato l’elettrobisturi. Non sono emerse differenze nel tempo di esecuzione dell’intervento, al contrario sono state registrate significative differenze nella riduzione del sanguinamento e del drenaggio post-operatorio. Le forbici ad ultrasuoni, in conclusione, si sono dimostrate uno strumento chirurgico di facile utilizzo che agevola l’esecuzione della dissezione ascellare.

    English version: The ultrasound scissors are recently emerging as an alternative surgical tool for dissection and haemostasis and have been extensively used in the field of minimally invasive surgery. We studied the utility and advantages of this instrument compared with electrocautery to perform axillary dissection. The operative and morbidity details of thirty-five breast cancer patients who underwent axillary dissection using the ultrasound scissors were compared with 35 matched controls operated with electrocautery by the same surgical team. There was no significant difference in the operating time between the ultrasound scissors and electrocautery group (36 and 30 mins, p>0.05). The blood loss (60 ± 35 ml and 294 ± 155 ml, p<0.001) and drainage volume (200 ± 130 ml and 450 ± 230 ml, p<0.001) were significantly lower in the ultrasound scissors group. There was a significant reduction of draining days in ultrasound scissors group (mean one and four days, respectively p<0.05). There was significant difference in the seroma rate between the two groups (10% and 30%, respectively). Axillary dissection using harmonic scalpel is feasible and the learning curve is short. Ultrasound scissor significantly reduces the blood loss and duration of drainage as compared to electrocautery.

  • KEY WORDS: Axillary dissection - Ultrasound scissors. Dissezione ascellare - Forbici ad ultrasuoni