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Surgery Today

, Volume 36, Issue 10, pp 908–913 | Cite as

Comparison of Monopolar Electrocoagulation, Bipolar Electrocoagulation, Ultracision, and Ligasure

  • Theodore Diamantis
  • Michael Kontos
  • Antonios Arvelakis
  • Spiridon Syroukis
  • Dimitris Koronarchis
  • Apostolos Papalois
  • Emmanuel Agapitos
  • Elias Bastounis
  • Andreas C. Lazaris
Article

Abstract

Purpose

Hemostasis is a fundamental principle of surgery. We compared the safety and efficacy of monopolar electrocoagulation (ME), bipolar electrocoagulation (BE), Ligasure (LS), a modern bipolar vessel sealing system, and Ultracision (UC), a system of ultrasound energy based shears. We also studied the healing process after their use.

Methods

We used each of the above methods to coagulate and divide the short gastric vessels of 16 white male New Zealand rabbits. The animals were killed after 3, 7, 14, or 21 days, and the coagulation sites and the adjacent gastric wall were examined histologically.

Results

LS and UC achieved complete hemostasis without any complications. Conversely, ME and BE often resulted in failed coagulation and perforation of the neighboring gastric wall from a side thermal injury. Histologically, LS demonstrated the mildest side thermal injury and the fastest healing process. We noted greater thermal injury and inflammatory response after UC than after LS on days 7 and 14; however, ME and BE caused the most severe lesions.

Conclusions

LS and UC are clearly the safest and most efficient methods of coagulation, whereas ME and BE could cause serious clinical and histological complications. We found histological evidence that UC causes a slightly greater inflammatory response than LS, and the clinical implications of this warrant further investigation.

Key words

Monopolar Bipolar Ligasure Ultracision Hemostasis 

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Copyright information

© Springer-Verlag Tokyo 2006

Authors and Affiliations

  • Theodore Diamantis
    • 1
  • Michael Kontos
    • 1
  • Antonios Arvelakis
    • 1
  • Spiridon Syroukis
    • 1
  • Dimitris Koronarchis
    • 1
  • Apostolos Papalois
    • 1
  • Emmanuel Agapitos
    • 2
  • Elias Bastounis
    • 1
  • Andreas C. Lazaris
    • 2
  1. 1.First Department of Surgery“Laiko” General Hospital National and Kapodistrian University of AthensAthensGreece
  2. 2.First Department of PathologyNational and Kapodistrian University of AthensGoudiAthensGreece

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