نام وسیله : قیچی اندوسکوپی (Endoscopic scissors)
قیچی اندوسکوپی (Endoscopic scissors) : دارای تیغه های کرو ، بانوک مدور و بلانت است .
مورد استفاده :جهت بریدن و جداکردن بافت ها ، عروق و نخ های بخیه کاربرد دارد .
سایر اسامی : Coag scissors ، Endo shears
توضیحات بیشتر : معمولا ، قیچی اندوسکوپی دارای قابلیت اتصال به کوتر مونوپولار هستند .
محل اتصال کابل کوتر ، در انتهای دسته آن قرار دارد (یک میله کوچک طلایی رنگ) که با پدال پایی می توان جریان را برقرار نمود.
The tremendous demand by woman of all ages for cellulite therapy has resulted in several studies to find the best cellulite treatment. Both noninvasive and invasive techniques have been described in literature. However, the treatments in these studies lacked long-term efficacy and longevity . In fact, no one treatment is completely successful .
Noninvasive therapies, such as endermologie, phosphatidylcholine, mesotherapy, radiofrequency devices, extracorporeal shock wave therapy, and several topical therapies may show some improvement, but all these therapies need multiple sessions, have questionable long-term sustainability, and are not cost effective .
Invasive therapies for cellulite have been shown to be more efficacious when compared to noninvasive therapy. Liposuction is considered outdated according to recent reports indicating that manual liposuction results in poor cosmetic outcome and actually might cause exaggeration of cellulite.
Another modality of treatment, ultrasound-assisted liposuction, was found to be safe and less destructive to the connective tissue than the conventional liposuction technique .
To date, it is unknown whether to consider the preservation of such connective tissue in ultrasound-assisted liposuction superior. Laser-assisted liposuction was suggested as superior to manual liposuction in treating small surface areas of cellulite, but supporting evidence is absent in the literature.
DESCRIPTION OF THE TECHNIQUE
The patient is positioned in a standing posture with overhead lighting to exaggerate the cellulite and locate it better. It is marked with any color the surgeon feels comfortable with; we prefer red for its convenience (Figure 1). The patient is brought into the operating room and prepped, and the areas to be treated are sterilized in the usual manner.
A standard Klein’s tumescent anesthesia is infiltrated into the region, ensuring adequate infusion of both superficial and deep fat layers. If the patient was scheduled for liposuction in the same area, cellulite treatment is undertaken first to ensure that the cellulitic bands are still under tension;
this helps capture and release the bands, analogous to someone holding a string tight while you cut it with scissors. Given the length of the endoscopic scissors, the entry wound may be placed in a concealed region, even if some distance from the cellulite. The choice of using straight versus curved-tip scissors is entirely up to the surgeon;
they both work. We opted to use curved ones simply because we feel they offer more control over the orientation of the tip direction in relation to the location of the cellulitic band (Figure 2). The endoscopic scissors are introduced with the tips closed and oriented superiorly.
When the surgeon reaches the cellulitic band, the scissors are opened to hook the band and secure it between the blades of the scissors. The band is released with the scissors; this may require one to three snips. The procedure is demonstrated in the video link. (https: //youtu.be/x96GuqcTrW).