In the field of gynecological surgery, there are a variety of surgical instruments, each of which has its own unique performance, scope of application, etc. The following is a comparative analysis of hysteroscopic forceps with several common instruments from different aspects:
Comparison with laparoscopic surgical instruments
Structural and functional characteristics
- Hysteroscopic forceps: Generally, the size is relatively small, which is to adapt to the relatively narrow operating space of the uterine cavity. The surgical forceps are composed of a forceps head, a forceps rod and a forceps handle. Different types of hysteroscopic forceps have single functions and strong pertinence. For example, 0° separation forceps are used to separate tissues, and tissue removal forceps are used to remove diseased tissues.
- Laparoscopic surgical instruments: The laparoscope consists of a laparoscopic camera system, laparoscopic surgical instruments and a laparoscopic workstation. Laparoscopic surgical instruments include various clamps, scissors, suction devices, etc., which is a set of diversified instrument systems. Laparoscopic surgical instruments need to be inserted into the abdominal cavity through a small hole in the abdominal wall, so the instrument rod is longer, and it needs to be able to work with the camera system, etc., to observe and operate organs in a relatively large space in the abdominal cavity.
Scope of application
- Hysteroscopic surgical forceps: Mainly used for the diagnosis and treatment of diseases in the uterine cavity, such as clamping and separating lesions such as endometrial polyps and submucosal uterine myomas, as well as removing foreign bodies in the uterus and endometrial biopsy, etc., suitable for the treatment of local lesions in the uterine cavity.
- Laparoscopic surgical instruments: The scope is wider and can be used for gynecological adnexal surgery, such as ovarian cyst removal and fallopian tube surgery. It can also be used in the field of general surgery for the treatment of gallbladder diseases and gastrointestinal tumors. It covers multiple organs in the abdominal cavity and different types of surgery, and is suitable for a variety of surgical scenarios involving abdominal organs.
Surgical trauma
- Hysteroscopic surgical forceps: Entering the uterine cavity through the natural cavity (vagina and cervix), there is basically no additional damage to other tissues and organs of the human body, no incision on the body surface, very small trauma, fast recovery after surgery, and little impact on the patient's daily life.
- Laparoscopic surgical instruments: It is necessary to make a hole in the abdominal wall. Although it is minimally invasive, there is still some abdominal wall damage compared to hysteroscopic surgery. However, compared with traditional open surgery, its trauma has been greatly reduced.
Comparison with hysteroscopic resectoscope
Working principle
- Hysteroscopic surgical forceps: It mainly clamps, separates and grasps tissues by mechanical means. Its actions are completed by the doctor's hand operation of the forceps handle, and does not involve the effect of electrical energy converted into heat energy on the tissue.
- Hysteroscopic resectoscope: It uses the heat energy generated by high-frequency current to cut and coagulate tissue. It transmits electrical energy to the tissue through electrodes, so that the tissue is destroyed by high temperature in an instant, thereby achieving the purpose of cutting or hemostasis.
Safety and tissue damage
- Hysteroscopic surgical forceps: The operation is relatively gentle, and the damage to the surrounding normal tissue is mainly mechanical squeezing and tearing. As long as the operation is standardized, the damage to normal tissue is limited to the clamping site, which will not cause large-scale thermal damage, and there are relatively few postoperative complications.
- Hysteroscopic resectoscope: During use, the heat generated by the electric energy may spread to the surrounding tissues, causing a certain degree of thermal damage to the surrounding normal tissues, which may cause complications such as postoperative adhesions. And if the intraoperative electric cutting power, time, etc. are not properly controlled, serious adverse events such as uterine perforation may occur.
Applicable disease conditions
- Hysteroscopic surgical forceps: More suitable for lesions with soft texture, small volume, and relatively easy to reach, such as small endometrial polyps or separation of loose adhesions in the uterine cavity.
- Hysteroscopic resectoscope: More suitable for dealing with larger and harder lesions, such as larger uterine submucosal myomas, uterine septa, etc., which can effectively cut and remove these lesions, but require higher operating skills and experience of doctors.
Comparison with hysteroscopic biopsy brush
Tissue acquisition method
- Hysteroscopic surgical forceps: It can directly clamp the lesion tissue, and the obtained tissue block is relatively large and complete, which can clearly observe the morphology and structure of the tissue, and provide a good specimen basis for accurately judging the nature of the lesion and conducting pathological diagnosis.
- Hysteroscopic biopsy brush: It is to obtain samples by brushing tissue cells, mainly collecting cells on the surface of the lesion. What is obtained is a cell specimen rather than a complete tissue.
Diagnostic accuracy
- Hysteroscopic surgical forceps: Since the tissue block is obtained, the classification, grading and histological characteristics of the disease are more accurate in pathological diagnosis, and the reliability of diagnosis is higher, especially suitable for suspected tumors and other situations where a clear histological diagnosis is required.
- Hysteroscopic biopsy brush: The obtained cell specimens are sometimes affected by factors such as the sampling site and the number of cells, and may not accurately reflect the full picture of the lesion. The diagnostic specificity is relatively low, but it also has application value in some cases where it is used for preliminary screening or is not suitable for surgical forceps.
Convenience of operation
- Hysteroscopic surgical forceps: The operation is relatively complicated, requiring certain skills to accurately clamp the target tissue, and if bleeding is encountered during the operation, additional steps such as hemostasis may be required.
- Hysteroscopic biopsy brush: The operation is relatively simple and convenient, and the sample collection can be completed quickly, the stimulation to the patient is relatively small, and the operation time may also be relatively short.
