ABSTRACT
Introduction: Major head and neck surgery involve dissections close to crucial structures such as nerves and vessels. For this reason, it is very important to use safe instruments for dissection and hemostasis. In a wide variety of surgical procedures, advanced vessel sealing devices are replacing traditional techniques for vessel ligation. Aim: Our study aimed to compare the bipolar vessel sealing system versus suture ligation in selective neck dissection in patients with oral cancer. Methods: This prospective comparative study was conducted to compare the outcome of the bipolar vessel sealing system versus suture ligation in selective neck dissection in patients with oral cancer. Out of 40 patients enrolled in the study, 20 patients were in Group A (bipolar vessel sealing system) and 20 patients in Group B (Suture ligation). The outcome measures recorded were blood loss, operating time, duration of hospital stay, pre-operative blood transfusion, Fromme’s surgical field scale, post-operative pain, and drainage volume. Treatment protocol and follow-up protocol were followed and the results were statistically analyzed and discussed. Results: Out of 40 patients, 20 patients had bipolar vessel sealing system and 20 patients had suture ligation. In bipolar vessel sealing system of 20 patients, 12 patients were male and 8 patients were female, mean value of blood loss is 26.84 ± 22.34 ml, operating time is 48.56 ± 5.48 min, duration of hospital stay is 12.92 ± 1.28 days, mean value of post-operative pain in day 0 is 3.5 ± 1, day 1 is 3.1 ± 1, day 2 is 1.8 ± 0.5, and day 3 is 1.1 ± 0.5, and drainage volume (ml) in 24 h is 72.48 ± 28.46, 48 h is 24.57 ± 18.29, and 72 h is 7.24 ± 6.7. In suture ligation of 20 patients, 15 patients were male and 5 patients were female, mean value of blood loss is 39.28 ± 16.44 ml, operating time is 54.22 ± 4.14 min, duration of hospital stay is 13.87 ± 1.42 days, mean value of post-operative pain in day 0 is 4.01 ± 0.9, day 1 is 3.8 ± 1.1, day 2 is 2.4 ± 0.6, and day 3 is 1.6 ± 0.8, and drainage volume (ml) in 24 h is 98.28 ± 36.87, 48 h is 41.28 ± 21.24, and 72 h is 18.29 ± 9.45. Conclusion: Bipolar vessel sealing system is more efficacious in terms of reducing blood loss, operating time, and better surgical field than conventional suture ligation. Thus, bipolar vessel sealing system is more advantageous compared to the traditional techniques, from both a clinical and economic point of view.
ABSTRACT
Objective To evaluate the safety and efficacy of ligasure vessel sealing system (LVSS) and conventional ligation haemostasis in thyroidectomy.Methods Pubmed,EMBASE,Medline,and CNKI were performed to search for randomized controlled trial.Literature selection and data collection were completed by 2 researchers independently.The assessment of methodological quality was conducted with Cochrane Handbook 5.1.The Review Manager software 5.2 was used for Meta analysis.Results A total of 11 studies (934 patients) were involved.Meta-analysis indicated that the operation time was shorter in LVSS group [WMD=-12.47,95％ CI (-18.33,-6.61),P＜0.0001].No significant difference was found in intra-operative blood loss,incidence of hypocalcaemia,recurrent laryngeal nerve (RLN) injury,or hospitalization time between the 2 groups (P＞0.05).Conclusion LVSS can reduce the operation time without increasing intra-operative blood loss,incidence of hypocalcemia,RLN injury,or hospitalization time,which is a safe and effective haemostasis method.
ABSTRACT
Objective To compare the clinical therapeutic effect of LigaSure vessel sealing system ,ultrasonic scalpel and mo‐nopolar high frequency electrocautery in open thyroid operation .Methods 293 cases of thyroid operation sequentially admitted in our hospital and in accordance with the inclusion criteria were collected and divided into three groups by the method of random dig ‐its table .There were 98 cases in the LigaSure vessel sealing system group (L‐Sure group) ,100 cases in the ultrasonic scalpel (US group) and 95 cases in the monopolar high frequency electrocautery (M‐E group) .The intraoperative and postoperative conditions were compared among 3 groups .Results The operation time ,intraoperative amount of bleeding and postoperative drainage in the L‐S group and the US group were significantly less than those in the M‐E group (P0 .05) .Conclusion The LigaSure vessel sealing system and ultrasonic scalpel can shorten the operation time ,reduce the amount of bleeding and postoperative drainage ,relieve pain and reduce the hospitalization duration .
ABSTRACT
Cada día es más frecuente en la cirugia tiroidea, el uso de sistemas electromecánicos como método hemostático, en oposicion a la hemostasia convencional. Se realiza un estudio comparativo entre el sistema de sellado de vasos sanguíneos LigaSure® y la hemostasia convencional con ligadura. Se analizaron 113 historias de pacientes sometidos a cirugia tiroidea, evaluando estudios preoperatorios, indicación quirúrgica, complicaciones intra y postoperatorias, reintervención, tiempo quirúrgico, días de hospitalización y resultados de anatomía patológica. Entre enero 2002 y diciembre del 2012, se realizaron 113 tiroidectomías; 52 con el método habitual de ligadura y en 61 pacientes se utilizó como método hemostático el LigaSure®. El promedio de edad fue de 41,3 y 46 años respectivamente; el diagnóstico fue de carcinoma papilar en 19,2% y 22,9%. El tiempo de duración del acto quirúrgico en el grupo de hemostasia convencional fue de 78,8 minutos y en el grupo con sellado de vaso de 74,4 minutos, con un drenaje postoperatorio de 85 y 71 cc para cada grupo. Los días de hospitalizacion fue 3,1 y 2,19. En cuanto a complicaciones: el hematoma post operatorio, con reintervencion (2 casos en ligadura convencional, 1 con el LigaSure®); lesión del nervio recurrente laríngeo (1 caso en cada grupo), hipocalcemia transitoria (3 casos en el grupo convencional y 1 caso en el grupo de LigaSure®); un paciente ameritó traqueostomía en el grupo de LigaSure®. En conclusión, la hemostasia en la tiroidectomía utilizando el metodo de sellado de vasos con LigaSure®, permite la realización del acto quirurgico con comodidad y seguridad, con una ligera ventaja que al utilizar métodos convencionales.
Every day, it is more common in thyroid surgery, the use of electromechanical systems, as hemostatic method in thyroid surgery, as opposed to conventional hemostasis. A comparative study between blood vessel sealing system LigaSure® and conventional hemostasis with ligation was carried out. 113 patients records who underwent thyroid surgery, evaluating preoperative studies, surgical indication, intra and postoperative complications, reoperation, surgical time, days of hospitalization and pathological anatomy results were analized. Between january 2002 and december 2012, 113 thyroidectomies were performed; 52 with the usual ligature method and 61 patients with the LigaSure® hemostatic method. The average age was 41.3 and 46 years respectively; papillary carcinoma was diagnosed in 19,2% and 22,9%. The duration of surgery in the conventional hemostasis group was 78.8 minutes and 74.4 minutes in the vessel sealing group, with a postoperative drainage of 85 and 71 cc for each group. The days of hospitalization were 3.1 and 2.19. In terms of complications: postoperative hematoma with reoperation (2 cases in the conventional group and 1 case in the LigaSure® group); recurrent laryngeal nerve lesion (1 case in each group), transient hypocalcemia (3 cases in the conventional group and 1 case in the LigaSure® group); one patient required tracheostomy in the LigaSure® group. In conclusion, hemostasis in thyroidectomy using the LigaSure® vessel sealing method, allows the realization of surgery in comfort and safety with a slight advantage to conventional methods.
ABSTRACT
OBJECTIVE: A number of new techniques have been developed to prevent lymphocele formation after pelvic lymphadenectomy in gynecologic cancers. We assessed whether the electrothermal bipolar vessel sealing device (EBVSD) could decrease the incidence of postoperative lymphocele secondary to pelvic lymphadenectomy. METHODS: A total of 321 patients with gynecologic cancer underwent pelvic lymphadenectomy from 2005 to 2011. Pelvic lymphadenectomy without EBVSD was performed in 134 patients, and pelvic lymphadenectomy with EBVSD was performed in 187 patients. We retrospectively compared the incidence of lymphocele and symptoms between both groups. RESULTS: Four to 8 weeks after operation, 108 cases of lymphocele (34%) were detected by computed tomography scan examination. The incidence of lymphocele after pelvic lymphadenectomy was 56% (75/134) in the tie ligation group, and 18% (33/187) in the EBVSD group. We found a statistically significant difference in the incidence of lymphocele between both groups (p<0.01). To detect the independent risk factor for lymphocele development, we performed multivariate analysis with logistic regression for three variables (device, number of dissected lymph nodes, and operation time). Among these variables, we found a significant difference (p<0.001) for only one device. CONCLUSION: Use of the EBVSD during gynecological cancer operation is useful for preventing the development of lymphocele secondary to pelvic lymphadenectomy.
Subject(s)
Adult , Female , Humans , Middle Aged , Electrocoagulation/instrumentation , Genital Neoplasms, Female/pathology , Lymph Node Excision/adverse effects , Lymphatic Metastasis , Lymphocele/etiology , Neoplasm Staging , Pelvis , Retrospective Studies , Risk FactorsABSTRACT
Background: Tonsillectomy is one of the most common procedures performed by otolaryngologists. Intraoperative bleeding is a significant problem which requires hemostasis and causes prolonged operative time. Several different techniques are used to perform this operation. The vessel sealing system (VSST) has been widely used in head and neck surgery because of its effectiveness and safety. Objective: To compare intraoperative blood loss, operation time, postoperative pain, and postoperative adverse effects (bleeding and others) between VSST and cold knife tonsillectomy (CKT). Materials and methods: This project was conducted at the Department of Otolaryngology, King Chulalongkorn Memorial Hospital. Twenty-three subjects, designed for tonsillectomy and qualified in eligible criteria, were enrolled consecutively. Interventions were randomized and performed using VSST on one side of tonsil and CKT on the other side. Measured outcomes for efficacy and adverse effects were intraoperative blood loss, operation, time, postoperative pain in Faces Pain Scale-Revised, postoperative bleeding, and other adverse effects byblinded assessors until postoperative day 14. Results: Efficacy of VSST was significantly better than CKT in intraoperative blood loss and operation time. Intraoperative blood loss by VSST, CKT, and their paired difference was 1.00, 25.00, and 20.00 mL (median) (p \< 0.01), respectively. Operation time by VSST, CKT, and their paired difference was 3.70±2.27, 8.52±4.79, and 4.83±4.60 minutes (Mean±SD), respectively. There was no significant difference in daily (day 0-14) postoperative pain between VSST and CKT groups. Only two cases of delayed (after 24 hours) postoperative bleeding were found on CKT side. Conclusion: VSST was better than CKT in efficacy (intraoperative blood loss and operation time) but not different in postoperative pain.
ABSTRACT
Objective To investigate the value of LigaSure vessel sealing system for surgery in gastroenteric cancer. Methods From January to September 2009,44 cases of gastroenteric cancer were operated by using LigaSure vessel sealing system,including 13 cases of gastric cancer, 14 cases of colon cancer, 17 cases of rectum cancer. Laparoscopy was employed in 10 cases. Results All the cases were performed successfully. The operation time was 130-250 min, the blood loss was 50-250 ml, and the number of lymph nodes resected was 4-20. None of the cases had serious complications. Conclusion As an optimal hemostatic tool, LigaSure vessel sealing system is safe and feasible for gastroenteric cancer.
ABSTRACT
Objective To explore the value of Ligasure vessel sealing system(LVSS)during resection of retroperitoneal tumor.Methods Group 1 including 32 cases were performed resection of retroperitoneal tumor with LVSS and electrosurgical seapel from Jun.2004 to Oct.2008.group 2 including 26 cases were done with electrosurgieal seapel from Jan.2001 to Jun.2004.Operating blood loss,operating time,iatrogenic injury,postoperative blood loss and hospital stay were compared between the two groups.Results There was no significant difference in hospital stay[(11.7±0.7)d vs.(12.3±1.4)d)]and iatrogenic injury(9.38%vs.16.00%)between two groups statistically(P＞0.05),but the intraoperative blood lose[(403.1±37.1)ml vs.(704.0±129.0)m1)s,postoperative blood loss[(131.5±18.4)ml vs.(214.8±29.2)ml)]and operating time[(166.5±8.9)min vs.(186.8±15.4)min]were less in group 1 than that in group 2(P＜0.05).Conclusion Ligasure vessel sealing system has advantages of safe coagulation,shortening operation time in resection of retroperitoneal tumor.
ABSTRACT
Objective To investigate the clinical value of different treatments of uterine artery and vein in laparoscopic hysterectomy. Methods In 184 patients accepting lapaxoscopie hysterectomy, ligasttre vessel sealing system ,was applied to uterine vessels, while bipolar electric coagulation to coagulate the uterine vessels during the operation. Results Among the groups, women undergoing ligasure hand the smaller amount of estimated blood loss and was associated with shorter operating time, there were statistically significant differences among the two groups( P＜0.01). Conclusion Each of the two operative ways is feasible or laparoacopic hysterectomy. The way of dissociating uteri arteriovenous completely before they were cut off with ligasure in laparoscopic panhysterectomy has many important clinical value such as easy appliance, safety, convenient operation, clear operation field and so on.
ABSTRACT
Objective To explore the value of the LigaSure vessel sealing in laparoscopic nephrectomy surgery. Methods Laparoscopic nephreetomies were performed in 41 cases from May 2004 to December 2006 by using LigaSure, including simple nephrectomies, radical nephrectomies and nephroureterectomies. The operative time, estimated blood loss, open conversion rate, duration of postoperative drainage, total amount of postoperative drainage, postoperative hospital day as well as complication rate were recorded and analyzed retrospectively. Results All procedures were finished successfully without conversion to open surgery. No severe vascular complication or other serious complications happened. The mean operative time was 146min (range, 35-240 min) ; mean blood loss was 163ml (range, 30-450 ml); mean time for postoperative drainage was 3d (range, 1-6 d) ; mean amount of postoperative drainage was 229ml (range, 45-435 ml). The postoperative hospital staying was 6-21 d, with the average of 10 days. Conclusions The LigaSure vessel sealing system produees a consistent, reliable, permanent seal of veins, arteries, and tissue bundles. It could decrease operative time and blood loss. This new energy-based vessel-ligation device appears to be effective in advanced laparoscopic procedures.
ABSTRACT
Objective To examine the practicability and security of the LigaSureTM vessel-sealing system in radical gastrcctomy.Methods Seventy patients of stage Ⅰ～Ⅲ gastric cancer undergone radical gastrectomy were analyzed retrospectively.Thirty-five radical gastrectomy were performed with LigaSureTM vessel-sealing system,the other 35 eases were performed without LigaSureTM.The operative duration,volume of intraoperative hemorrhage,and postoperative complications were analyzed.Results There were significant difference in both operative duration[(159.9±24.7)min vs(172.6±23.7)min,P＜0.05]and volume of intraoperative hemorrhage[(335.7±40.3)ml vs(371.7±43.2)ml,P＜0.01].There was no significant difference in the postoperative complications between LigaSureTM group and conventional method group.All patients recovered without severe postoperative complications.Conclusion Radical resection of gastric cancer using LigaSureTM instead of conventional hand tie method appears to he shorten operative duration,decreased volume of intraoperative hemorrhage.And the technique is convenient and safe.
ABSTRACT
Objective To investigate the clinical efficacy of LigaSure vessel sealing system(LVSS)in laparoscopic splenectomy(LS).Methods From August 2005 to September 2006,11 cases underwent LS with LVSS.LVSS was applied to cut off lienocolic ligament and gastrosplenic ligament,and separate splenic artery from the superior border of spleen tail and blocked by an absorbable clip,and then splenic stalk was separated and cut off near the hilum of spleen with LVSS.Results LS was successfully completed in 10 cases,in which 9 with LVSS entirely,and 1 case used Endo-GIA due to difficulties in splenic stalk separation.And one case was converted to laparotomy for close adhesion of spleen with the surrounding tissues.The operation time was 60-150 min,110 min in average;blood loss was 80-400 ml.No complications such as postoperative massive hemorrhage,pancreatic leakage,or gastric leakage occured.Conclusions Application of LVSS in LS is characterized by safety,reliable hemostasis,and leaving no internal foreign body.
ABSTRACT
Objective To explore the value of Ligasure and Ultracision in total laparoscopic hysterectomy (TLH). Methods From January 2002 to December 2006,totally 225 patients received total laparoscopic hysterectomy in our hospital. Among the cases,Ligasure was used in 152 patients,and Ultracision were employed in 72. The clinical data of the patients were reviewed. Results The mean operation time in the Ligasure group was significantly shorter than that in the Ultracision group [(104.9?29.2) min vs. (152.4?46.6) min,t=-9.329,P=0.000]. And the mean blood loss of the Ligasure group was significantly less than that in the other group [(32.9?14.9) ml vs. (126.4?12.1) ml,t=-46.710,P=0.000]. In both the groups,no patient was converted to open surgery or developed complications or surgical injuries. Conclusions Both Ligasure and Ultracision are safe and effective for total laparoscopic hysterectomy. Ligasure is superior in the management of uterine vessels,while the Ultracision is more effective in opening the vesicle and separating the cardinal ligament.
ABSTRACT
Objective To evaluate the usefulness of the LigaSure vessel sealing system for vascular control during transvaginal hysterectomy and compared it with suture group. Methods One hundred and sixty-one transvaginal hysterectomy were performed with LigaSure while 62 with traditional suture from Sept 2002 to Mar 2003. Meanwhile, the operating time, the estimated blood loss, the postoperative recovery and hospital stay were explored. Results All of the surgery were successfully performed with both LigaSure and traditional suture. Compared with suture group the LigaSure has many advantages in operating time, estimated blood loss and postoperative recovery. Conclusion For transvaginal hysterectomy LigaSure vessel sealing system is a more useful instrument and also an ideal option. It may be used safely in large, difficult uterus during transvaginal hysterectomy with less blood lose, short operating time, quick recovery after surgery.