An Alternative Method of Smoke and Blood Evacuation During Endonasal Endoscopic Dacryocystorhinostomy
During endonasal endoscopic dacryocystorhinostomy EERDCR use of radiofrequency knife is accompanied by appearance of tissue destruction products which makes it difficult to visualize operation space. An aspiration cannula for evacuation of smoke and blood inserted into the nasal cavity limits the amplitude of instruments movements and creates difficulties for manipulations. To reduce the number of instruments used during the procedure, to provide more space for manipulation and visualization to improve the working area, as well as reduce the risk of complications is proposed to use a new method of blood and smoke evacuation.
Summary of Content
The suggested technique is as follows. For dissection of soft tissues we used a modified Javate electrode for Surgitron DF120 united with aspiration system. For this purpose the electrode was placed into a silicone tube 5 mm in diameter. The working part of the electrode remained free. The peripheral end of the tube was connected to a vacuum pump. We have performed 42 EERDCR operations with bicanalicular implants. Two of them were reoperations. Mean age of the patients was 46 years, there were 9 males and 29 females. Follow-up period was from 6 to 18 months. No complications were marked during operations. Operation time varied from 15 to 22.5 minutes. The results were estimated in three months, after lacrimal implants removal. Tear outflow was restored in 39 of 42 cases. Bleeding was insignificant during surgery and was absent in the early post-op period. No cases of orbital fat prolapse, liquorrhea, diplopia or visual functions lesion were marked.
The combination of aspiration system with Javate electrode gives a possibility to reduce the number of instruments used during intervention, provides more space for manipulations, improves visualization of operation zone, and reduces risk of complications. The combination of two instruments in one probe gives the surgeon a possibility to perform manipulations more quickly and without help from an assistant. Availability of the silicone tube allows its single use.
[ Keyword ]
endoscopic dacryocystorhinostomy / smoke evacuation
[ Conflict of Interest ]