Abstract
BackgroundEfficient hemostatic techniques are essential in laparoscopic surgery for ideal intraoperative and postoperative results. A variety of advanced devices are available for the sealing of major vascular structures. The aim of this study is to assess effectiveness and safety of major vessel sealing with a radiofrequency device during laparoscopic colorectal resections for cancer based on the experience of a single hospital.MethodsEarly outcomes of a consecutive series of patients who received elective laparoscopic colorectal resections for cancer over a 10-year period (January 2008–September 2017) are analyzed.In all procedures, the Ligasure® electrothermal bipolar device was used for the closure of the major colonic vessels and the dissection of all the structures. No other products such clips, staplers, hemostatic products, or other devices were used.ResultsSeven-hundred fifty-nine procedures were performed in laparoscopy: 179 rectal resections, 247 sigmoidectomies and left hemicolectomies, 240 right hemicolectomies, 33 resections of the splenic flexure, 35 transverse colonic resections, and 25 other procedures.In 39 cases, the laparoscopic procedure was converted to open surgery, and in these cases, vessel sealing was also achieved with the radiofrequency device alone.Vessel dissection and sealing was realized in all cases without any intraoperative or postoperative bleeding. No reoperations for bleeding from major vessels were performed in any patients. One case of reoperation was recorded postoperatively, at 3 h after right hemicolectomy, due to a small bleeding from the fat of the transverse colon stump.ConclusionsThe use of Ligasure® radiofrequency device for sealing and dividing the major colonic vessels is safe, fast, and effective during laparoscopic colorectal resections.
Highlights
Laparoscopic colorectal resection has become widespread due to the well-known benefits that it provides
Study population The population was composed of 759 consecutive unselected patients (339 males and 420 females) The mean age was 68.2 ± 10.92 (22–89) years, the mean BMI was 26.0 ± 3.77 (18.7–35.9) kg/m2, the rate of previous intraperitoneal surgery was 30.8%, 150 patients were American Society of Anesthesiology Score (ASA) I, 419 patients were ASA II, and 190 patients were ASA III (Table 1)
The exposure of the colorectal vessels varied among the patients and procedures, but this did not appear to be a critical factor in vessel sealing
Summary
Laparoscopic colorectal resection has become widespread due to the well-known benefits that it provides. Conventional monopolar tools increase the risk of thermal injury, make hemostasis difficult, produce smoke, and often require additional tools, such as Currently, new energy-based devices are available to reduce the length of surgery and minimize blood loss while producing a major hemostatic effect. Most of these devices use radiofrequency (i.e., electrothermal bipolar vessel sealers; EBVSs), ultrasound (i.e., ultrasonic shears; USs), or even combine these energies with conventional bipolar energy [1]. The aim of this study is to assess effectiveness and safety of major vessel sealing with a radiofrequency device during laparoscopic colorectal resections for cancer based on the experience of a single hospital
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
