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A new bipolar feedback-controlled sealing system for closure of the cystic duct and artery

Surgical Endoscopy and Other Interventional Techniques volume 16, pages 812–813 (2002)Cite this article

Abstract

Background

Bile leaks are serious complications after laparoscopic cholecystectomy. The aim of this study was to evaluate the feasibility of closure of the cystic duct with a new feedback-controlled bipolar sealing system (LigaSure).

Methods

Ten domestic pigs underwent open cholecystectomy with the cystic duct and artery dissected and sealed with the new bipolar sealing system (LigaSure). Four and 8 days postoperatively, 5 pigs each were sacrificed and the closure of the cystic duct was evaluated. The cystic stump and the common bile duct were excised for histological examination.

Results

None of the pigs had a bile leak or a biliary peritonitis. There were no signs of postoperative bleeding or inflammation in Calots triangle. Histology showed total necrosis of the cystic duct in the first two pigs due to too much energy used. The remaining specimens showed a regularly scaling zone without necrosis in 7 cases, and in one case a partial necrosis in the mucosa only was found.

Conclusion

Cystic artery and cystic duct closure with the new device may be an alternative to the clip. Further trials should evaluate the feasibility and safety of the new device in the clinical setting.

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Affiliations

  1. Ludwig Boltzmann Institute for Operative Laparoscopy and 2nd Surgical Department, General Hospital Linz, Krankenhausstraße 9, 4020, Linz, Austria

    A. Shamiyeh, P. Schrenk & W. Wayand

  2. Surgical Clinic Country Hospital Zala, Zalaegerszeg, Hungary

    L. Tulipan & P. Vattay

  3. Institute for Pathology, General Hospital Linz, Krankenhausstraße 9, 4020, Linz, Austria

    S. Bogner

Authors
  1. A. Shamiyeh
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  2. P. Schrenk
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  3. L. Tulipan
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  4. P. Vattay
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  5. S. Bogner
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  6. W. Wayand
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Additional information

Online publication: 8 February 2002

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Shamiyeh, A., Schrenk, P., Tulipan, L. et al. A new bipolar feedback-controlled sealing system for closure of the cystic duct and artery. Surg Endosc 16, 812–813 (2002). https://doi.org/10.1007/s00464-001-9058-x

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  • DOI: https://doi.org/10.1007/s00464-001-9058-x

Key words

  • Laparoscopic cholecystectomy
  • Cystic stump
  • Bipolar coagulation
  • Bile leak