Use of a radiofrequency probe for tenoscopic-guided annular ligament desmotomy.
Use of a radiofrequency probe for tenoscopic-guided annular ligament desmotomy.
复制标题
使用射频探头进行腱镜引导的环形韧带切断术。
DOI：
10.1111/j.2042-3306.2011.00454.x
复制
发表时间：
2012
影响因子：
2.2
通讯作者：
Goodrich,LR
中科院分区：
文献类型：
--
作者：
McCoy,AM;Goodrich,LR
进行研究的原因：环状韧带切断术通常在患有慢性腱鞘炎的马身上进行。先前报道的腱鞘镜技术存在与出血和笨拙仪器相关的局限性。射频 (RF) 能量可提供精确性和出色的止血效果，可能是马匹环形韧带尖锐横断术的良好替代方案。目的：描述一种使用射频探头进行腱镜引导环形韧带切断术的技术，并报告进行该手术的马的临床结果。方法：使用尸体标本 (n = 14) 和接受不相关终末手术的活马 (n = 2) 来优化腱镜引导下射频环形韧带切断术。检查了 2003 年至 2008 年使用射频探针进行环形韧带断端切除术的所有马的记录，术后可进行超过 1 年的随访。结果：使用 2 种不同的市售射频探针，在尸体和活马模型四肢中成功横切环形韧带。通过实践实现了完全横断，并在大体解剖中得到确认。组织病理学未发现周围组织有任何附带损伤。 7 例临床病例中的 6 例可进行超过 1 年的随访。六匹马中有四匹返回工作岗位。业主对所有病例的结果都感到满意。结论：使用射频探头进行间肌切断术可以在腱镜引导下进行精确的组织横切，而不会损坏周围结构或出血。凭借经验，这是一项易于执行的技术。在临床患者中，可能会获得可接受的结果。潜在相关性：与之前报道的技术相比，腱镜引导的射频环形韧带切断术具有多种优点，包括可靠的止血和精确的组织横切术，并且是治疗患有环形韧带间质炎和腱鞘内其他复杂病理的马的可行的手术替代方案。
Reasons for performing study:Annular ligament desmotomy is commonly performed in horses with chronic tenosynovitis. Previously reported tenoscopic techniques have limitations related to haemorrhage and awkward instrumentation. Radiofrequency (RF) energy affords precision and excellent haemostasis and may be a good alternative to sharp transection of the annular ligament in horses.Objective:To describe a technique for using a RF probe for tenoscopic‐guided annular ligament desmotomy and to report the clinical outcome of horses in which it was performed.Methods:Cadaver specimens (n = 14) and live horses undergoing unrelated terminal procedures (n = 2) were used to optimise the tenoscopic‐guided RF annular ligament desmotomy technique. Records were examined for all horses undergoing annular ligament desmotomy with an RF probe from 2003 to 2008 for which follow‐up of >1 year post operatively was available.Results:The annular ligament was successfully transected in the cadaver and live horse model limbs using 2 different commercially available RF probes. Complete transection was achieved with practice and confirmed on gross dissection. Histopathology did not reveal any collateral damage to surrounding tissue. Follow‐up of >1 year was available for 6 of 7 clinical cases. Four of 6 horses returned to work. Owners were satisfied with the outcome in all cases.Conclusions:Desmotomy using a RF probe allows precise tissue transection under tenoscopic guidance without damage to surrounding structures or haemorrhage. With experience, it is an easily performed technique. In clinical patients, an acceptable outcome may be expected.Potential relevance:Tenoscopic‐guided RF annular ligament desmotomy offers advantages, including reliable haemostasis and precise tissue transection, over previously reported techniques and is a viable surgical alternative for treating horses with annular ligament desmitis and other complex pathology within the tendon sheath.