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Pierazzi DM, Pica Alfieri E, Cuomo R, Bocchiotti MA, Grimaldi L, Donniacuo A, Zerini I, Nisi G. Ligasure™ Impact and Ligasure™ Small Jaw in Body Contouring after Massive Weight Loss: A New Perspective. J INVEST SURG 2021; 35:659-666. [PMID: 33691572 DOI: 10.1080/08941939.2021.1897714] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND The most effective dissection technique for elevating flaps in body contouring is still controversial, particularly in high-risk massive weight loss (MWL) patients. LigaSure (Medtronic, Dublin, Ireland) is an energy device commonly used among different surgical specialties to reduce morbidity and improve outcomes. The aim of this study is to investigate the effectiveness of LigaSure Impact and LigaSure Small Jaw in body contouring after MWL compared with conventional technique. MATERIAL AND METHODS Patients who underwent abdominoplasty, mastopexy, brachioplasty and thigh lift after MWL at a single center from 1 December 2018 to 1 March 2020 were retrospectively reviewed. In each procedure patients were divided into two groups according to the dissection technique: LigaSure group and monopolar electrosurgery group. Patients characteristics, perioperative details and postoperative complications were evaluated. RESULTS Fourty-five patients underwent abdominoplasty, twenty-six mastopexy, twenty brachioplasty and sixteen medial thigh lift. Using LigaSure, operative time was longer in abdominoplasty and thigh lift, but shorter in mastopexy and brachioplasty. Although not statistically significant, the amount of blood and serum recorded from drains in the first 36 hours was reduced in LigaSure groups. Additional analgesic intake was reduced with LigaSure as well as postoperative subjective pain. In all body contouring procedures statistically significant difference was found in days of hospital stay favoring LigaSure groups. Complications occurred most frequently in control groups compared to LigaSure groups. CONCLUSION LigaSure Impact and LigaSure Small Jaw may be beneficial in improving outcomes because they might reduce fluids drainage, analgesics intake, hospital stay and postoperative complications.
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Affiliation(s)
- Diletta Maria Pierazzi
- Division of Plastic and Reconstructive Surgery; Department of Medicine, Surgery and Neuroscience, "Santa Maria alle Scotte" Hospital, University of Siena, Italy
| | - Edoardo Pica Alfieri
- Division of Plastic and Reconstructive Surgery; Department of Medicine, Surgery and Neuroscience, "Santa Maria alle Scotte" Hospital, University of Siena, Italy
| | - Roberto Cuomo
- Division of Plastic and Reconstructive Surgery; Department of Medicine, Surgery and Neuroscience, "Santa Maria alle Scotte" Hospital, University of Siena, Italy
| | - Maria Alessandra Bocchiotti
- Division of Plastic and Reconstructive Surgery; Department of Surgery, Città della Salute e della Scienza Hospital, Molinette Ospital Unit, University of Turin, Italy
| | - Luca Grimaldi
- Division of Plastic and Reconstructive Surgery; Department of Medicine, Surgery and Neuroscience, "Santa Maria alle Scotte" Hospital, University of Siena, Italy
| | | | - Irene Zerini
- Division of Plastic and Reconstructive Surgery; Department of Medicine, Surgery and Neuroscience, "Santa Maria alle Scotte" Hospital, University of Siena, Italy
| | - Giuseppe Nisi
- Division of Plastic and Reconstructive Surgery; Department of Medicine, Surgery and Neuroscience, "Santa Maria alle Scotte" Hospital, University of Siena, Italy
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Laparoscopic transperitoneal adrenalectomy: a comparative study of different techniques for vessel sealing. Surg Endosc 2020; 35:673-683. [PMID: 32072291 DOI: 10.1007/s00464-020-07432-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Accepted: 02/10/2020] [Indexed: 10/25/2022]
Abstract
BACKGROUND Laparoscopic adrenalectomy is the standard surgical approach to adrenal lesions. Adrenal vessel sealing is the critical surgical phase of laparoscopic adrenalectomy. This study aimed at comparing perioperative outcomes of laparoscopic transperitoneal adrenalectomy by means of radiofrequency energy-based device (LARFD) to those performed with traditional clipping device (LACD), while focusing on the different adrenal vessel control techniques. METHODS Patients who underwent adrenalectomy for adrenal disease between January 1994 and April 2019 at the Surgical Clinic, Polytechnic University of Marche were included in the study. Overall, 414 patients met inclusion criteria for study eligibility: 211 and 203 patients underwent LARFD and LACD, respectively. Multiple models of quantile regression, logistic regression and Poisson finite mixture regression were used to assess the relationship between operative time, conversion to open procedure, length of stay (LoS), surgical procedure and patient characteristics, respectively. RESULTS LARFD reduced operative time of about 12 min compared to LACD. Additional operative time-related factors were surgery side, surgery approach, conversion to open procedure and trocar number. The probability of conversion to open procedure decreased by about 76% for each added trocar, whereas it increased by about 49% for each added centimeter of adrenal lesion and by about 25% for each added year of surgery. Two patient clusters were identified based on the LoS: long-stay and short-stay. In the long-stay cluster, LoS decreased of about 30% in LARFD group and it was significantly associated with conversion to open procedure and postoperative complications, whereas in short-stay cluster only postoperative complications had a significant effect on LoS. CONCLUSION Laparoscopic transperitoneal adrenalectomy performed by means of radiofrequency energy-based device for the sealing of adrenal vessels is an effective procedure reducing operative time with potentially improved postoperative outcomes.
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Oltmann SC, Chen H. The transabdominal minimally invasive approach to the isolated adrenal mass. INTERNATIONAL JOURNAL OF ENDOCRINE ONCOLOGY 2015. [DOI: 10.2217/ije.15.11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Tumor size, previous abdominal operation, medical comorbidities and surgeon skill set are factors to determine if a minimally invasive approach is feasible for patients with benign adrenal pathology, as patient outcomes are far superior with this approach. Laparoscopic techniques have largely replaced the open operations, and are often viewed as the standard of care for many general surgery operations. For this reason, general surgeons are very familiar with the anatomy within the peritoneal cavity. Often, the skill set from one advanced laparoscopic procedure may translate to another, potentially allowing a low volume adrenal surgeon but high volume laparoscopic surgeon to safely perform transabdominal laparoscopic adrenalectomy.
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Affiliation(s)
- Sarah C Oltmann
- Department of Surgery, University of Texas Southwestern Medical Center, 5323 Harry Hines, Dallas, TX 75390-9092, USA
| | - Herbert Chen
- Department of Surgery, University of Wisconsin, 600 Highland Ave., Madison, WI 53792, USA
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Solaini L, Arru L, Merigo G, Tomasoni M, Gheza F, Tiberio GAM. Advanced sealing and dissecting devices in laparoscopic adrenal surgery. JSLS 2014; 17:622-6. [PMID: 24398206 PMCID: PMC3866068 DOI: 10.4293/108680813x13693422520350] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES This study sought to analyze the impact of advanced sealing/dissecting devices on operative and postoperative outcomes in laparoscopic adrenalectomy. METHOD Patients were divided into three groups according to the devices used during their procedures [electrothermal bipolar vessel system (EBVS), ultrasound shears (US), and monopolar electrocautery (ME)]. A comparison of the perioperative outcomes was performed. RESULTS Conversion rates and intraoperative and postoperative complication rates did not differ among the three groups. Major blood loss that required transfusion was registered in only two cases, all of which were performed with ME. Procedures with EBVS were shorter than those with US or ME. For left adrenalectomies only, operative times were similar for US and EBVS. The use of EBVS was found to be an independent predictor of decreased operative time. CONCLUSION The use of advanced sealing devices was associated with reduced operative time, with particular benefits in left adrenalectomy. EBVS and US may provide better hemostasis than ME.
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Affiliation(s)
- Leonardo Solaini
- Surgical Clinic, Department of Medical and Experimental Sciences, University of Brescia, Pl.e Spedali Civili 1, Brescia, Italy.
| | - Luca Arru
- Surgical Clinic, Department of Medical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Giulia Merigo
- Surgical Clinic, Department of Medical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Matteo Tomasoni
- Surgical Clinic, Department of Medical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Federico Gheza
- Surgical Clinic, Department of Medical and Experimental Sciences, University of Brescia, Brescia, Italy
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Lopez J, Vilallonga R, Targarona EM, Balague C, Enriquez L, Rivera R, Balibrea JM, Perez-Ochoa F, Rodriguez K, Baeza M, Reyes A. Can LigaSure™ be used to perform sleeve gastrectomy? – Tensile strength and histological changes. MINIM INVASIV THER 2013; 23:144-51. [DOI: 10.3109/13645706.2013.875924] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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Common uses and cited complications of energy in surgery. Surg Endosc 2013; 27:3056-72. [PMID: 23609857 DOI: 10.1007/s00464-013-2823-9] [Citation(s) in RCA: 85] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2012] [Accepted: 11/05/2012] [Indexed: 12/13/2022]
Abstract
BACKGROUND Instruments that apply energy to cut, coagulate, and dissect tissue with minimal bleeding facilitate surgery. The improper use of energy devices may increase patient morbidity and mortality. The current article reviews various energy sources in terms of their common uses and safe practices. METHODS For the purpose of this review, a general search was conducted through NCBI, SpringerLink, and Google. Articles describing laparoscopic or minimally invasive surgeries using single or multiple energy sources are considered, as are articles comparing various commercial energy devices in laboratory settings. Keywords, such as laparoscopy, energy, laser, electrosurgery, monopolar, bipolar, harmonic, ultrasonic, cryosurgery, argon beam, laser, complications, and death were used in the search. RESULTS A review of the literature shows that the performance of the energy devices depends upon the type of procedure. There is no consensus as to which device is optimal for a given procedure. The technical skill level of the surgeon and the knowledge about the devices are both important factors in deciding safe outcomes. CONCLUSIONS As new energy devices enter the market increases, surgeons should be aware of their indicated use in laparoscopic, endoscopic, and open surgery.
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Ip JCY, Lee JC, Sidhu SB. Laparoscopic Adrenalectomy: The Transperitoneal Approach. CURRENT SURGERY REPORTS 2012. [DOI: 10.1007/s40137-012-0002-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Manassero M, Leperlier D, Vallefuoco R, Viateau V. Laparoscopic ovariectomy in dogs using a single-port multiple-access device. Vet Rec 2012; 171:69. [DOI: 10.1136/vr.100060] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- M. Manassero
- Service de chirurgie; Centre Hospitalier Vétérinaire d’Alfort; Ecole Nationale Vétérinaire d’Alfort; Maisons-Alfort 94700 France
| | - D. Leperlier
- Service de chirurgie; Centre Hospitalier Vétérinaire d’Alfort; Ecole Nationale Vétérinaire d’Alfort; Maisons-Alfort 94700 France
| | - R. Vallefuoco
- Service de chirurgie; Centre Hospitalier Vétérinaire d’Alfort; Ecole Nationale Vétérinaire d’Alfort; Maisons-Alfort 94700 France
| | - V. Viateau
- Service de chirurgie; Centre Hospitalier Vétérinaire d’Alfort; Ecole Nationale Vétérinaire d’Alfort; Maisons-Alfort 94700 France
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The use of LigaSure Vessel Sealing System in Ivor Lewis esophagectomy. J Cardiothorac Surg 2012; 7:10. [PMID: 22273539 PMCID: PMC3277476 DOI: 10.1186/1749-8090-7-10] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2011] [Accepted: 01/24/2012] [Indexed: 11/10/2022] Open
Abstract
Background This study investigated the results of the LigaSure Vessel Sealing System (LVSS), which has been routinely used in esophageal resections in our clinic since 2006. Methods For this purpose, 60 patients who underwent Ivor Lewis esophagectomy were included in the study. The results were compared with the patients who underwent stomach mobilising procedure and esophagectomy with conventional methods (conventional group) before 2006 and the patients who underwent LVSS (group of LigaSure) in surgical cases after 2006. The cases were compared particularly in terms of intraoperative bleeding, operative time, duration of postoperative hospital stay, intraoperative complications, mortality, and morbidity. Results Of the patients, 34 (% 56.6) were female and 26 (43.3%) were male, and the range of the age was between 33 and 78, and the mean age of the patients was 52.73 ± 11,617. While the amount of intraoperative bleeding was 321.864 ± 575.00 ml in the conventional group, this was found to be 370.31 ± 238.456 ml in the LigaSure group (p = 0.007). In the statistical evaluation of the operative time, the mean duration was determined as 310.00 ± 24.795 minutes in the conventional group, whereas it was determined as 265.16 ± 31.353 minutes in the LigaSure group (p = 0.001). Conclusions The use of LVSS was associated with a significant reduction in the operative time and the rate of intra-operative complications.
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Gaujoux S, Bonnet S, Leconte M, Zohar S, Bertherat J, Bertagna X, Dousset B. Risk factors for conversion and complications after unilateral laparoscopic adrenalectomy. Br J Surg 2011; 98:1392-9. [PMID: 21618212 DOI: 10.1002/bjs.7558] [Citation(s) in RCA: 66] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/23/2011] [Indexed: 01/08/2023]
Abstract
BACKGROUND Laparoscopic adrenalectomy (LA) is the procedure of choice for surgical management of most benign adrenal tumours, with a reported overall complication rate around 10 per cent. The aim of this study was to determine predictive factors for postoperative complications and conversion to open surgery after unilateral LA. METHODS From 1994 to 2009, consecutive patients undergoing unilateral LA by the lateral transabdominal approach were analysed from a prospectively maintained database. A mass larger than 12 cm in diameter and suspected primary adrenal carcinoma were considered contraindications to LA. Predictive factors for postoperative complications and conversion to open surgery were analysed. RESULTS Some 462 patients were analysed. There were no postoperative deaths. Postoperative complications occurred in 53 patients (11·5 per cent), medical complications in 28, and surgical complications in 33 patients. Six patients underwent reoperation for complications. Multivariable logistic regression analysis showed that conversion to open surgery (odds ratio (OR) 6·20, 95 per cent confidence interval 2·08 to 18·53; P = 0·001) and left-sided tumour (OR 1·89, 1·02 to 3·52; P = 0·044) were independent predictive factors for overall complications. Conversion to open surgery was the only independent predictive factor for medical complications (OR 12·88, 4·21 to 39·41; P = 0·001), and left-sided LA was the only predictive factor for surgical complications (OR 2·22, 1·01 to 4·89; P = 0·047). No factor was predictive of conversion to open surgery. CONCLUSION In this single-institution study, conversion to open surgery and left-sided tumours were independent predictive factors for overall complications, but none of the variables analysed was predictive of conversion.
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Affiliation(s)
- S Gaujoux
- Department of Digestive and Endocrine Surgery, Cochin Hospital, Assistance Publique-Hôpitaux de Paris, Université Paris Descartes, Paris, France
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Clipless and Sutureless Laparoscopic Adrenalectomy Carried Out With the LigaSure Device in 32 Patients. Surg Laparosc Endosc Percutan Tech 2010; 20:109-13. [DOI: 10.1097/sle.0b013e3181ced190] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Culp WTN, Mayhew PD, Brown DC. The effect of laparoscopic versus open ovariectomy on postsurgical activity in small dogs. Vet Surg 2009; 38:811-7. [PMID: 19781023 DOI: 10.1111/j.1532-950x.2009.00572.x] [Citation(s) in RCA: 175] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To describe a technique for laparoscopic ovariectomy (LapOVE) in small dogs, and compare the surgical time, complications, and postoperative activity of dogs undergoing LapOVE to those undergoing conventional traditional open ovariectomy (OOVE). STUDY DESIGN A randomized, controlled clinical trial. ANIMALS Intact small breed (<10 kg) female dogs (n=20). METHODS Ventral median celiotomy was performed for OOVE. A 2-midline portal technique using a 3.5 mm laparoscope port and a 6 mm instrument portal was used for LapOVE. An accelerometer was attached to the collar of each dog to record 24-hour preoperative and 48-hour postoperative activity. Total activity counts recorded before surgery were compared with total counts recorded after surgery. The percent change in counts after surgery was compared between OOVE- and LapOVE-treated dogs. RESULTS No major complications occurred and surgical time for LapOVE was significantly longer than for OOVE cases (P=.005). Dogs in the LapOVE group had a 25% decrease in total activity counts after surgery (95% confidence interval [CI]: 11-38%), whereas dogs in the OOVE group had a 62% decrease in total activity counts after surgery (95% CI: 48-76%). CONCLUSIONS Both procedures were performed with reasonable surgical times and without major complication. Postoperative activity, as measured by accelerometry, was significantly different between the 2 groups. CLINICAL RELEVANCE Laparoscopy is a safe method for ovariectomy in small dogs and results in increased postoperative activity counts when compared with an open technique.
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Affiliation(s)
- William T N Culp
- Department of Clinical Studies-Philadelphia, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA, USA.
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Sartori PV, Romano F, Uggeri F, Colombo G, Caprotti R, Giannattasio C, Scotti MA, Delitala A, Prada M, Uggeri F. Energy-based hemostatic devices in laparoscopic adrenalectomy. Langenbecks Arch Surg 2009; 395:111-4. [PMID: 19937340 DOI: 10.1007/s00423-009-0563-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2009] [Accepted: 10/12/2009] [Indexed: 11/26/2022]
Abstract
PURPOSE In literature, few papers compare different hemostatic devices in laparoscopic adrenalectomy. This sequential cohort study analyzes the outcomes of laparoscopic adrenalectomy performed by different hemostatic instruments, to evaluate if any of them has any advantage over the other and as secondary endpoints, the impact of body mass index (BMI) and tumor size on the indication, and the outcome of laparoscopic adrenalectomy. METHODS Forty-six patients, aged 54.6 +/- 46 years, underwent laparoscopic adrenalectomy over 5 years. Mean BMI was 27 +/- 4.8 kg/m(2). Twenty-four patients had a left tumor, and 22 had a right one. Patients were divided into two groups according to the hemostatic device: Ultracision was used in 26 patients, and Ligasure was used in 20. Groups were well matched for histology, tumor size and site, BMI, gender, and age. RESULTS Mean operating time was 126.5 +/- 52 min, blood losses were 101 +/- 169 mm, conversion rate was 6.5%, morbidity was 26%, and hospitalization was 5.3 +/- 2.5 days. Groups did not differ for surgical time, blood losses, complications, and conversion rate; BMI and length of surgery were not related. Tumor side and size did not affect surgical time, regardless of the hemostatic tool. Patients submitted to left adrenalectomy bled more (p = 0.007) and had more complications (p = 0.016) than those undergone operation on the right side. CONCLUSIONS Obesity (BMI > 30) and large masses do not contraindicate laparoscopic adrenalectomy. Left adrenalectomies bleed more and have a higher morbidity. Hemostatic device choice is up to surgeon's preference.
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Affiliation(s)
- Paola Vincenza Sartori
- 1st Surgical Department, S. Gerardo Hospital, University of Milan Bicocca, Via Pergolesi 33, 20052, Monza, Italy.
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The effects of LigaSure on the laparoscopic management of acute appendicitis: "LigaSure assisted laparoscopic appendectomy". Surg Laparosc Endosc Percutan Tech 2009; 19:333-5. [PMID: 19692885 DOI: 10.1097/sle.0b013e3181a99288] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
A very important step in laparoscopic appendectomy is dissection of the appendiceal mesenteric pedicle. The aim of this study was to investigate the effect of LigaSure in laparoscopic appendectomy. Between August 2007 and June 2008, a total of 32 patients were included in the study. Patients were randomized into 2 groups. The first group's dissection of the mesoappendix was performed with LigaSure (5 to 10 mm), whereas the second group's with endodissector and endoclip. The surgical time, postoperative complications, additional analgesics use and hospital stay were compared. There were no significant differences in complication rates, use of analgesics and hospital stay between the groups. The operation time (49.06+/-14.73 min vs. 59.69+/-12.54 min, P=0.036) was significantly lower in the LigaSure group. This study demonstrates that dissection of the mesoappendix with LigaSure reduces the operation time and could be used safely. However, more experiences are needed to attain reliable scientific results.
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The use of electrothermal bipolar vessel sealing system in minimally invasive video-assisted thyroidectomy (MIVAT). Surg Laparosc Endosc Percutan Tech 2008; 18:493-7. [PMID: 18936674 DOI: 10.1097/sle.0b013e3181775afd] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
PURPOSE Options for controlling hemostasis during endoscopic thyroid surgery include vessel clips and ultrasonic technology. The aim of this study was to evaluate the use of the electrothermal bipolar vessel sealing system on the performance of minimally invasive video-assisted thyroidectomy (MIVAT). METHODS Between January 2006 and July 2007, 63 consecutive patients underwent MIVAT. The operative time, complications, and hospital stay were analyzed prospectively. As endoscopic instruments are important variables for incision length, the mini-incision was routinely measured at the end of the endoscopic procedure and compared with the initial standard approach (ie, 1.5 cm). RESULTS The mean operative time for lobectomy was 49.5 minutes (range, 39 to 120) and for total thyroidectomy 97.6 (59 to 130) minutes. No cases required conversion to open surgery and none involved significant intraoperative complications. Postoperative recovery was uneventful in all procedures. All patients were satisfied with the cosmetic results. At the end of the procedure, the mean length of the incision was not significantly increased. CONCLUSIONS This study showed that the utilization of electrothermal bipolar vessel sealing system for MIVAT is feasible and safe. A reduction of the rates for postoperative complications such as hypoparathyroidism and recurrent laryngeal nerve injuries was not possible to demonstrate in the present study.
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Hemostatic Properties of Four Devices for Partial Nephrectomy: A Comparative ex Vivo Study. J Endourol 2008; 22:1071-6. [DOI: 10.1089/end.2007.0236] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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