In Luna which energy source is better to use?
| Discussion in 'All Categories' started by Dr Srilata - Jun 4th, 2016 9:31 am. | |
Dr Srilata
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Dear Sir, If I am planning to do LUNA for chronic pelvic pain which energy source I use use like, Harmonic scalpel, Ligasure or Bipolar or Monopolar. |
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re: In Luna which energy source is better to use?
by Dr R K Mishra -
Jun 5th, 2016
1:10 am
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Dr R K Mishra
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Dear Dr. Srilata Laparoscopic uterosacral nerve ablation surgery is an ancillary procedures meant to decrease endometriosis-associated pelvic pain symptoms. This create paracervical uterine denervation, involving transection of the uterosacral ligament at its attachment to the uterus creating denervation of sympathetic nerves and the S1S4 parasympathetic nerves, which transmit pain stimuli from the supravaginal region into the uterine cervix. Laparoscopic Surgery for the treatment of peritoneal endometriosis by LUNA does not have a very good success rate. Anyway if you want to do it it is always preferable to use Bipolar. Monopolar is not good as it has potential risk of remote injury to ureter. Bipolar Forceps or Robi Dissector is a good instrument. Laparoscopic ROBI Dissector is a rotating bipolar maryland which is very safe in this surgery. Just you have to burn both the side of uterosacral ligament where it is attached with the cervix of uterus. This technique involves not separation and transection, but ablation of the uterosacral ligaments to achieve pain control. Laparoscopic Uterine nerve ablation if properly done involves the cauterization by Robi dissector resulting in denervation of nerve going through Uterosacral ligaments close to their point of insertion into the cervix. The procedure interrupts pelvic afferent sensory nerve fibers of the Lee–Frankenhauser nerve plexus. |
