Bipolar Vessel Sealing System Versus Suture Ligation in Selective Neck Dissection
To evaluate whether the use of electrothermal bipolar vessel sealing system reduces the blood loss and operating time, with lesser complications as compared to suture ligation in selective neck dissection in patients with oral cancer.
Materials and Methods
The study was conducted in the Department of Oral and Maxillofacial Surgery of our institute from January 2015 to December 2016. The sample consisted of 60 patients, divided into Groups I and II with 30 subjects in each. In Group I electrothermal bipolar vessel sealer and in Group II suture ligation were used. The outcome measures recorded were: blood loss, operating time, quality of surgical field, postoperative pain on days 1, 2, and 3, drainage volume at 24, 48, and 72 h, edema, complications, and duration of hospital stay.
There were 36 males and 24 females with a mean age of 50.76 ± 12.6 years. Blood loss was significantly less for Group I than for Group II (p = 0.001); the operating time was significantly less in Group I than in Group II (p = 0.001); Group I had better quality of surgical field (p = 0.001); less pain on postoperative evening, day 2 and day 3 (p < 0.05); and less drainage volume at 24 and 48 h (p < 0.05). Postoperative edema, complications, need for perioperative blood transfusion, and duration of hospital stay postsurgery were similar in both groups.
The electrothermal bipolar vessel sealer was efficacious in terms of reducing blood loss and operating time while providing a better surgical field and patient compliance without increasing the perioperative morbidity.
KeywordsElectrothermal bipolar vessel sealer Suture ligation Selective neck dissection
We would like to show our gratitude toward all the patients who were part of this study for being cooperative and supportive throughout the research. We are highly thankful to Dr. Bana Bihari Mishra, Associate Professor, Department of General Surgery, VIMSAR, Burla, and Dr. Bipin Bihari Pradhan, Professor and Head, Department of Physiology, SCBMCH, Cuttack for their immense help and valuable guidance during the study. We are very grateful to Dr. Debashish Pati and Dr. Brundabati Meher for helping and preparing the final manuscript. Finally, we would like to thank all those who directly and indirectly became part of this study.
Compliance with Ethical Standards
Conflict of interest
- 2.Landman J, Kerbl K, Rehman J et al (2003) Evaluation of a vessel sealing system, bipolar electrosurgery, harmonic scalpel, titanium clips, endoscopic gastrointestinal anastomosis vascular staples and sutures for arterial and venous ligation in a porcine mode. J Urol 169:697–700PubMedCrossRefGoogle Scholar
- 7.Janssen PF, Brölmann HAM, Huirne JAF (2012) Effectiveness of electrothermal bipolar vessel-sealing devices versus other electrothermal and ultrasonic devices for abdominal surgical hemostasis: a systematic review. Surg Endosc. https://doi.org/10.1007/s00464-012-2276-2276 PubMedCrossRefGoogle Scholar
- 14.Manouras A, Markogiannakis H, Koutras AS, Antonakis PT, Drimousis P, Lagoudianakis EE et al (2008) Thyroid surgery: comparison between the electrothermal bipolar vessel sealing system, harmonic scalpel, and classic suture ligation. Am J Surg. https://doi.org/10.1016/j.amjsurg.2007.01.037 PubMedCrossRefGoogle Scholar
- 24.Tirelli G, Camilot D, Bonini P, Del Piero GC, Biasotto M, Quatela E (2015) Harmonic scalpel and electrothermal bipolar vessel sealing system in head and neck surgery: a prospective study on tissue heating and histological damage on nerves. Ann Otol Rhinol Laryngol 124(11):852–858PubMedCrossRefGoogle Scholar