Ligasure versus EndoGIA Stapler for Hilar Vascular Control During Laparoscopic Splenectomy for Adult Chronic ITP

Abstract

Background: The major procedural risk associated with laparoscopic splenectomy (LS) for adult chronic immune thrombocytopenia (ITP), is uncontrollable intraoperative bleeding, requiring conversion to laparotomy. There are several methods of achieving hemostasis, including clips, sutures, Ligasure and EndoGIA stapler. Patients and methods: Between April 2015 and May 2017, 32 adult patients with chronic ITP indicated for LS, were divided into two equal groups, according to the method of hilar vascular control (group 1, Ligasure Vessel Sealing System; group 2, EndoGIA stapler). The perioperative course was documented and the follow up data were recorded. Results: Two patients (6.25%) were converted to open splenectomy. Four patients (12.5%) had persistent thrombocytopenia after surgery. The cost was higher in group B. No significant difference was found between both groups regarding post-operative complications. Conclusion: For adult chronic ITP, both Ligasure and EndoGIA stapler are safe and effective for hilar vascular control during LS. The results are similar and comparable, but Ligasure is less costly than EndoGIA stapler.