With continuous advancements in medical technology, laparoscopic surgery has emerged as a key treatment for intrauterine disorders and abnormal uterine bleeding in recent years, gaining broader clinical adoption.
Progress in minimally invasive techniques and instruments has expanded diagnostic and therapeutic options, offering significant benefits for both physicians and patients.
Below are several commonly used instruments and consumables.
（1）Trocar Series:
Used for Pneumoperitoneum Creation
It is made of high-quality stainless steel and consists of two parts: an outer sheath tube and a blunt-tipped inner stylet. The end of the outer sheath has a beveled surface, forming a sharp beveled edge. The inner stylet is slightly longer than the outer sheath, and a spring is installed at its rear end, allowing it to telescopically extend beyond the tip of the outer sheath.
When the trocar presses against the abdominal wall, the blunt tip retracts to expose the trocar's cutting edge for penetrating tissues. Once the peritoneum is penetrated, the blunt tip automatically pops out to protect the abdominal viscera.
A valve and a standard interface are also mounted at the tip of the outer sheath. When the valve is opened, gas flows in through the standard interface, passes through the valve, and then enters the abdominal cavity through the gap between the outer sheath and the inner stylet. Both the gas flow rate and pneumoperitoneum pressure are controlled by the set values of the automatic insufflator.
The trocar is a puncturing device that guides the trocar sheath into the abdominal cavity, while the trocar sheath serves as a channel for the laparoscope body and various surgical instruments to enter and exit the abdominal cavity. There are combinations of multiple diameter specifications, and various adapters are also provided, allowing the selection of different trocar combinations according to different surgical needs. Common lumen diameters include 5mm, 10mm, 15mm, and 20mm.
Trocars have two types of tips: pyramidal and conical. All trocar sheaths are equipped with valves and interfaces. The former can prevent the loss of gas in the abdominal cavity when the laparoscope body and surgical instruments enter or exit the abdominal cavity, while the latter can be connected to an insufflation device or used to discharge smoke generated during surgery.
In addition, there are disposable puncture trocars. The head of the puncture needle is equipped with a sheath protection device, and the tail is equipped with a compression spring to enable flexible expansion and contraction of the sheath. There is also an indicator mark; during surgery, the expansion and contraction status of the sheath can be judged by the indicator mark, which can effectively protect and prevent the puncture needle from damaging internal organs. Moreover, it can effectively maintain airtightness inside the trocar, making it convenient and simple to use. As a disposable instrument, it effectively avoids infection, so it is increasingly widely used in laparoscopic surgery.
Electrosurgical instruments mainly include monopolar, bipolar, and intelligent bipolar types (such as Ligasure and Biclamp). All of them are based on high-frequency electricity: a high-frequency current generator produces high-frequency electricity to perform various laparoscopic operations, including electrocoagulation, hemostasis, electrocision, and dissection.
One pole is outside the body, and the other is on the instrument. They can be used for cauterizing, desiccating, coagulating, and incising tissues. A closed circuit is formed by the high-frequency signal generator, surgical electrode knife, patient's tissue, patient electrode pad, and high-frequency signal generator.
It uses a specially designed bipolar instrument to apply a custom-modulated current to tissues. Based on intelligent tissue feedback, the thermal effect of the current denatures collagen, thereby fusing the collagen tissue in blood vessel walls to form a transparent coagulation band, which achieves the sealing effect. Its special current modulation and patented intelligent tissue feedback sensing technology can automatically stop power output, enabling safe sealing of the uterine artery in gynecological surgeries.
It combines real-time feedback technology and intelligent host technology, which can automatically identify and detect the impedance of the tissue clamped between the forceps based on real-time feedback, and instantly adjust the output current and voltage. Combined with the increased pressure between the electrocoagulation forceps, it dissolves and denatures collagen and fibrin in the blood vessel wall, fuses the blood vessel wall to form a transparent band, and achieves permanent lumen sealing. The formed sealing band can withstand 3 times the normal human arterial systolic pressure.
This system can be used for the safe sealing of various blood vessels with a diameter of 7mm or less, and can also be used for the treatment of ligaments and tissue bundles. Additionally, it has the advantage of minimal heat loss (with a lateral heat conduction distance of 1-2mm), which can greatly shorten the operation time and reduce bleeding.
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