International Journal of Colorectal Disease

, Volume 31, Issue 4, pp 903–908 | Cite as

Energy vessel sealing systems versus mechanical ligature of the inferior mesenteric artery in laparoscopic sigmoidectomy

  • Bertrand Trilling
  • Romain Riboud
  • Julio Abba
  • Edouard Girard
  • Jean-Luc Faucheron
Original Article
First Online:
Accepted:

Abstract

Purpose

With the development of new devices, our ligation technique of the inferior mesenteric artery changed from mechanical ligature (ML) to energized vessel sealing systems (EVSS) ligature. The aim of this study was to determine if EVSS could be considered as safe and effective as the more convention ML of the inferior mesenteric vessels division during elective laparoscopic left colectomy.

Methods

Between 2001 and 2014, 200 consecutive patients (111 males) of mean age 54.1 years were operated laparoscopically for a symptomatic sigmoid diverticulitis. Vascular interruptions were performed using mechanical ligatures including double clipping, staples or surgical thread (100 patients) or, starting from 2006, with EVSS thereafter (100 patients). Section of the inferior mesenteric artery is performed systematically at its origin in our institution for teaching purposes. Technical results were prospectively collected perioperatively and postoperatively.

Results

There was no mortality. Mean operating time was 253.7 and 200.7 min in the ML and EVSS groups, respectively (p < 0.001). Mean hospital stay was 10.4 and 8.1 days (p < 0.001). Thirty-day complications occurred in 31 versus 25 % of patients (p = 0.26). Leakage with peritonitis occurred in 3 patients in the ML group. Hemorrhagic events occurred in both groups (2 in ML group versus 1 in EVSS group). Limitations of the study are its retrospective design and the bias due to the comparison of two historical cohorts.

Conclusions

EVSS for the inferior mesenteric artery are as safe and effective as ML in elective sigmoidectomy for diverticular disease with lower operative time and hospital stay.

Keywords

Inferior mesenteric artery Energized vessel sealing systems Mechanical ligature Colectomy Laparoscopy Diverticulitis  
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Notes

Acknowledgments

The authors would like to kindly thank Ms. Genevieve Trilling and Lucie Trilling for English proofreading.

Compliance with ethical standards

Conflict of interest

Prof. Jean-Luc Faucheron received consultantships from AMI, from Ethicon, from Medtronic, from Sanofi, from MSD, and from Covidien, and non-financial support from Johnson & Johnson outside the submitted work.

Dr. Bertrand Trilling and Dr. Edouard Girard both received financial support for participating in congress from Nestlé and Takeda. Dr Bertrand Trilling received financial support for participating in congress from Ethicon.

The rest of the authors declare that they have no competing interests.

Funding

None.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2016

Authors and Affiliations

  • Bertrand Trilling
    • 1
    • 2
  • Romain Riboud
    • 1
    • 3
  • Julio Abba
    • 1
  • Edouard Girard
    • 1
    • 2
  • Jean-Luc Faucheron
    • 1
    • 2
  1. 1.Colorectal Unit, Department of SurgeryMichalon University HospitalGrenoble cedexFrance
  2. 2.Grenoble Alpes UniversityGrenobleFrance
  3. 3.Visceral Surgery DepartmentVoiron Regional HospitalVoironFrance

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