Abstract
Background
A newly available, laparoscopic 5-mm bipolar vessel sealing device promises substantial advantages over the 10-mm instrument. This study compared the safety as well as the technical and surgical aspects of these different tools.
Methods
For this study, 30 consecutive patients undergoing laparoscopic left-sided colectomy were prospectively randomized for the 5-mm LigaSure or The 10-mm LigaSure. The patients’ demographics were analyzed together with their intraoperative and postoperative parameters, and the instruments were assessed by the surgeons with a standardized questionnaire.
Results
The two groups were comparable and demonstrated similar mean operation times, blood losses, and hospital stays. The 5-mm LigaSure was applied in more operation steps and resulted in fewer bleeding episodes and less lens cleaning. Monopolar scissors were used less frequently in the 5-mm group, thus minimizing cauteric lesions and their complications (0 in the 5-mm group vs 2 in the 10-mm group). Overall satisfaction with the 5-mm LigaSure was significantly higher (8.4 ± 0.18 vs 6.9 ± 0.41 out of 10; p = 0.002), with significant advantages in terms of dissection capacity, visibility, and handling.
Conclusion
The 5-mm LigaSure is as secure and fast as the larger 10-mm device and compares favorably in terms of finer dissection as well as trocar flexibility and handling. Therefore, it can be used safely in laparoscopic colorectal surgery.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Dindo D, Demartines N, Clavien PA (2004) Classification of surgical complications: a new proposal with evaluation in a cohort of 6,336 patients and results of a survey. Ann Surg 240: 205–213
Fleshman J (2002) Advanced technology in the management of hemorrhoids: stapling, laser, harmonic scalpel, and LigaSure. J Gastrointest Surg 6: 299–301
Harold KL, Pollinger H, Matthews BD, Kercher KW, Sing RF, Heniford BT (2003) Comparison of ultrasonic energy, bipolar thermal energy, and vascular clips for the hemostasis of small-, medium-, and large-sized arteries. Surg Endosc 17: 1228–1230
Heniford BT, Matthews BD, Sing RF, Backus C, Pratt B, Greene FL (2001) Initial results with an electrothermal bipolar vessel sealer. Surg Endosc 15: 799–801
Kennedy JS, Stranahan PL, Taylor KD, Chandler JG (1998) High-burst-strength, feedback-controlled bipolar vessel sealing. Surg Endosc 12: 876–878
Kirdak T, Korun N, Ozguc H (2005) Use of LigaSure in thyroidectomy procedures: results of a prospective comparative study. World J Surg 29(6):771–774
Landman J, Kerbl K, Rehman J, Andreoni C, Humphrey PA, Collyer W, Olweny E, Sundaram C, Clayman RV (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 model. J Urol 169: 697–700
Lee WJ, Chen TC, Lai IR, Wang W, Huang MT (2003) Randomized clinical trial of LigaSure versus conventional surgery for extended gastric cancer resection. Br J Surg 90: 1493–1496
Matthews BD, Pratt BL, Backus CL, Kercher KW, Mostafa G, Lentzner A, Lipford EH, Sing RF, Heniford BT (2001) Effectiveness of the ultrasonic coagulating shears, LigaSure vessel sealer, and surgical clip application in biliary surgery: a comparative analysis. Am Surg 67: 901–906
Morino M, Rimonda R, Allaix ME, Giraudo G, Garrone C (2005) Ultrasonic versus standard electric dissection in laparoscopic colorectal surgery: a prospective randomized clinical trial. Ann Surg 242: 897–901; discussion 901
Romano F, Franciosi C, Caprotti R, Uggeri F (2005) Hepatic surgery using the Ligasure vessel sealing system. World J Surg 29: 110–112
Takada M, Ichihara T, Kuroda Y (2005) Comparative study of electrothermal bipolar vessel sealer and ultrasonic coagulating shears in laparoscopic colectomy. Surg Endosc 19: 226–228
Tekkis PP, Senagore AJ, Delaney CP, Fazio VW (2005) Evaluation of the learning curve in laparoscopic colorectal surgery: comparison of right-sided and left-sided resections. Ann Surg 242: 83–91
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Hübner, M., Hahnloser, D., Hetzer, F. et al. A prospective randomized comparison of two instruments for dissection and vessel sealing in laparoscopic colorectal surgery. Surg Endosc 21, 592–594 (2007). https://doi.org/10.1007/s00464-006-9034-6
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00464-006-9034-6