Md. Kamruzzaman Khan, FCPS, Md. Kamruzzaman Khan, FCPS, Md. Kamruzzaman Khan, FCPS. Bangabandhu Sheikh Mujib Medical University, Dhaka
Title of the article: Ball/ Globe diathermy instrument an essential instrument in laparoscopic surgical procedure.
Description of the technology and method of use or application
In laparoscopic procedure diathermy play key role in homeostasis. Use of instrument or diathermy varies from place to place as well on the organ/tissue working. In our practice we have to use diathermy in homeostasis of organ as well also in flat surface where diathermy use cannot be pinpointed as in case of vessels coagulation. At that case we see the surface bleeding (as happens oozing) from surfaces makes the work difficult. Use of pinpointing coagulation instruments is less useful do homeostasis the lacerated tissue where the bleeding point could not be pinpointed and homeostasis become difficult. In that case we need flat surface coagulating instrument which does not cause further trauma to the tissue and the lacerated tissue or surface could be compressed against major organ or tissue parts so that there should be coagulation of the lacerated tissue as well kept contract with the organ surfaces all most near anatomical relation. So that the coagulating surface will be in contract as well homeostasis.
Moreover, the surface oozing which cannot be managed by sharp instrument can be managing blunt instrument of ball/globe shaped. The size of the ball/globe should be selected along with the cautery capacity and surface on which it should be applied. It would be used along with a sucker nozzle where head is containing the ball or a simple stick. The rotation of the ball over the stick is permeable or not should be assessed.
Preliminary Result if available
In absence of ball diathermy instrument we use the curved forceps (the Maryland) to full fill the purpose. In some cases it gives good results. In other cases it could not work up to satisfaction as because the surface is less. Besides if the instruments is sharper/thinner then contact surface is less in that case the instrumental penetrate in side with diathermy timing so that it become difficult to detach instrument from coagulating surface as well there is scope to separation/takeout a part of the tissue of the forceps. Some other rounded tip instruments like sucker tip is unsuitable for this purpose.
Conclusion/future direction
The ball/globe diathermy will be good instrument in surface diathermy/trauma tissue or organ injured. The size of the ball should be selected along with the cautery capacity and surface on which it should be applied. The rotation of the ball over the stick is permeable or not should be assessed. Connection of sucker with ball may be more advantageous for work. If sucker should be added along with it should be stick lumen or which the ball set.
In my opinion we could think over a ball diathermy instrument for coagulation surface bleeding, injured organ and traumatized tissue.
Design of the proposed instruments
1. Fixed Ball with stick
2. Ball rotate over the stick
3. Fixed Ball with sucker lumen
inside stick
Session: Emerging Technology Poster
Program Number: ETP097
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