The role of the ultracision technique in visceral surgery. Ligature-free operation--an illusion?

Abstract

We report on 431 operations in conventional visceral surgery with the general use of the ultracision technique for preparation (thyroid resections n = 356, colonic resections n = 28, local excisions of the gastric wall n = 3, gastrectomy n = 14, anterior resections of the rectum n = 19, abdominoperineal resection of the rectum [Miles' operation] n = 11). Ligatures were only used for truncal blood vessel ligation. A thorough study of the technical possibilities is a prerequisite for the use of the ultracision technique. The general use of the ultracision technique leads to a revolutionary change of the surgical technique and saves a considerable amount of suture material. In combination with the use of bipolar electrocoagulation the ultracision technique makes the operation fast and leads to a major reduction of bleeding. The biggest disadvantage of the ultracision technique in comparison to the conventional surgical technique is the high cost of the device at present. Despite of savings of suture material, swabs and blood transfusions, the costs for the ultracision scissors are still higher due to its single use.