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Morbidity reduction using the vessel sealing device LigaSure™ in breast cancer surgery

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Summary

Background

Seroma formation is the major morbidity nuisance after breast cancer surgery. It prolonges hospital stay and causes infections and wound healing problems. The aim of the study was to evaluate the impact of the vessel sealing device LigaSure™ on postoperative morbidity especially seroma formation.

Methods

Between 2011 and 2012, data were retrospectively evaluated from 59 women with breast cancer who underwent axillary dissection at a university hospital. The Clavien Dindo Classification (CDC) was used to assess the severity of postoperative complications. Surgery was performed with LigaSure™ in 23 patients (39.0 %) compared with monopolar electrocautery in the control group.

Results

A total of 36 patients (61.0 %) had breast conserving surgery, and 5 patients (8.5 %) underwent isolated axillary dissection. Morbidity-associated re-operations were reported in 5.1 %. Seroma rates were nearly twice as high in the control group compared with LigaSure™ patients (p = 0.056). Hospital stay was shortened by 1 day using LigaSure™. The rate of punctures at the outpatient ward was half as high in the LigaSure™ cohort (21.7 vs. 41.7 %; p = 0.115). The frequency of aspirations (≤ 2 times) was lower in LigaSure™ patients. Despite this, the median puncture volume was higher (195 ml; IQR: 112.5–265 ml) in the LigaSure™ cohort as compared with the control group (100 ml; IQR: 60–180 ml). Overall, the CDC was significantly lower in the LigaSure™ group compared with the conventional cohort (p = 0.038).

Conclusions

The vessel sealing device LigaSure™ leads to a reduction of postoperative morbidity, hospital stay, and puncture frequency, which is desirable in terms of cost-effectiveness.

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Acknowledgments

The authors would like to thank Natalija Frank for carefully working on our database.

Conflict of interest

Peter Panhofer, Steffi Rothe, Michael Schütz, Barbara Grohmann-Izay, Peter Dubsky, Raimund Jakesz, and Michael Gnant have no personal or financial relationship to COVIDIEN MEDTRONIC. Florian Fitzal has had financial support from COVIDIEN concerning advanced training and science. Florian Fitzal has no financial support from COVIDIEN MEDTRONIC for the actual study.

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Authors and Affiliations

  1. Department of General Surgery, AKH—E 21 A, Breast Health Center, University Clinic of Surgery, Medical University of Vienna, Waehringer Guertel 18–20, 1090, Vienna, Austria

    P. Panhofer MD, MBA, S. Rothe MBA, M. Schütz MD, B. Grohmann-Izay MD, P. Dubsky MD, R. Jakesz MD & M. Gnant MD

  2. Breast Health Center, Krankenhaus der Barmherzigen Schwestern, Seilerstätte 4, Linz, Austria

    F. Fitzal MD

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  1. P. Panhofer MD, MBA
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Correspondence to P. Panhofer MD, MBA.

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Panhofer, P., Rothe, S., Schütz, M. et al. Morbidity reduction using the vessel sealing device LigaSure™ in breast cancer surgery. Eur Surg 47, 150–156 (2015). https://doi.org/10.1007/s10353-015-0334-8

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  • DOI: https://doi.org/10.1007/s10353-015-0334-8

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