Uso del Ligasure® para el sellado del conducto cístico en pacientes intervenidos por colecistectomía laparoscópica / Ligasure® use for cystic duct sealing in patients who underwent laparoscopic cholecystectomy

Con el objetivo de describir el uso del LigaSure® para el sellado del conducto cístico en pacientes intervenidos por colecistectomía laparoscópica en la Sociedad Anticancerosa del Estado Lara, durante el lapso junio 2012-junio 2017, se realizó un estudio descriptivo transversal de recolección retrospectiva de datos de 62 historias clínicas de pacientes intervenidos por colecistectomía laparoscópica asistida por sellado del conducto cístico con LigaSure® los cuales se caracterizaron por un promedio de edad de 47,58 ± 14,11 años, predominio del sexo femenino (64,52%) y un tiempo promedio quirúrgico de 41,74 ± 7,99 minutos. No se registraron complicaciones intraoperatorias ni postoperatorias y la estancia postquirúrgica en 77,42% de los pacientes fue de 24 horas. En conclusión, el uso del LigaSure® para el sellado del conducto cístico resultó una técnica segura para pacientes intervenidos por colecistectomía laparoscópica.

In order to describe LigaSure® use for sealing of the cystic duct in patients who underwent laparoscopic cholecystectomy in the Sociedad Anticancerosa del Estado Lara during the period June 2012-June 2017 we conducted a descriptive transversal study with retrospective data collection of 62 medical charts. Results show that the average patient age was 47.58 ± 14.11 years with a female predominance (64.52%) and an average surgical time of 41.74 ± 7.99 minutes. There was no intraoperative or postoperative complications and the postsurgical stay in 77.42% of patients was 24 hours. In conclusion, the use of LigaSure® for cystic duct sealing is a safe technique for patients who undergo laparoscopic cholecystectomy.

Comparison of the thermal damage of energy-based surgical devices during thyroid surgery / 中华内分泌外科杂志

Objective Energy based surgical devices such as high frequency electrotome,Harmonic scalpel and LigaSure are widely used in thyroid operations.This study is to demonstrate the difference of tissue thermal damage among different surgical instruments.Methods 12 beagle dogs were randomly divided into 3 groups,electrotome 15 W groups (group A),three-speed Harmonic scalpel (group B) and LigaSure middle gear group (group C).Patients of each group received energy instruments operating on their thyroid tissue which mimics traditional thyroidectomy.The temperatures of gland tissue during procedures were monitored by infrared thermal imager,and the operated thyroid tissues were histologically analyzed.Results The highest temperature was (83.9±8.2)℃ in the electrotome group,(70.7±7.5)℃ in three-speed Harmonic scalpel group,and (56.6±5.7)℃ in LigaSure group.The highest temperature among the three groups was statistically significant.The electrotome (15 W) caused more serious thermal damage to thyroid tissues than that caused by either the Harmonic scalpel or LigaSure (thermal damaged depth:(0.96±0.07) mm vs (0.74±0.07) mm,P＜0.01;(0.96±0.07) mm vs (0.72± 0.11) mm,P＜0.01).Nevertheless,the thermal damage had no significant differences between the Harmonic scalpel and LigaSure group (P=0.845).The thermal damage caused by the 15 W electrotome was significantly larger than that in the other two groups,and the difference had statistical significance (P＜0.01).Conclusion Compared to the high frequency electrotome,Harmonic scalpel and LigaSure lead less tissue thermal damage during thyroid surgeries,owing to less heat production.In that way,Harmonic scalpel and LigaSure are superior to electrotome in terms of safety.

Safety and efficacy of ligasure vessel sealing system for thyroidectomy: a Meta analysis / 中华内分泌外科杂志

Objective To evaluate the safety and efficacy of ligasure vessel sealing system (LVSS) and conventional ligation haemostasis in thyroidectomy.Methods Pubmed,EMBASE,Medline,and CNKI were performed to search for randomized controlled trial.Literature selection and data collection were completed by 2 researchers independently.The assessment of methodological quality was conducted with Cochrane Handbook 5.1.The Review Manager software 5.2 was used for Meta analysis.Results A total of 11 studies (934 patients) were involved.Meta-analysis indicated that the operation time was shorter in LVSS group [WMD=-12.47,95％ CI (-18.33,-6.61),P＜0.0001].No significant difference was found in intra-operative blood loss,incidence of hypocalcaemia,recurrent laryngeal nerve (RLN) injury,or hospitalization time between the 2 groups (P＞0.05).Conclusion LVSS can reduce the operation time without increasing intra-operative blood loss,incidence of hypocalcemia,RLN injury,or hospitalization time,which is a safe and effective haemostasis method.

Comparative study of seamless welding in cholecystectomy / 实用医学杂志

Objective To explore the feasibility of high-frequency electric welding systemin cholecyste-ctomy when compared with ultrasound scalpel , Ligasure and traditional scalpel. Methods Ninety-six rabbits were enrolled in the study and divided into high-frequency electric welding system group , ultrasound scalpel group , Ligasure group and traditional scalpel group. The working temperature was recorded. Eight rabbits of each group were killed to observe the occlusion at 1st, 4th, 7th day postoperatively. Tissues were collected for observation under HE staining. Results High-frequency electric welding system group excelled in operative time , bleeding, working temperature, granulation tissue and inflammatory reaction. No significant difference was found in preope-rative and postoperative liver function test. Conclusion High-frequency electric welding system in cholecyste-ctomy has similar effect as ultrasound scalpel and Ligasure.

Comparative research of the Harmonic Focus? and Ligasure Small Jaw? in open thyroid surgery / 中国癌症杂志

Background and purpose:In recent years, energy-based instruments have been widely used in today’s open surgeries. Harmonic Focus? (HF) and Ligasure Small Jaw? (LSJ) are both custom-made for thyroid open surgery. This study aimed to explore the effcacy and safety of HF and LSJ in open thyroidectomy.Methods:The data from patients who undertook total thyroidectomy with central neck dissection by the same surgeon during last year in this hospital were reviewed. HF was used in 100 patients, and LSJ was used in 104 patients. The effectiveness was appraised by comparing operation time and postoperative volume of drainage on the ifrst postoperative day. The safety was appraised by comparing the incidence of postoperative complications.Results:The results of the effectiveness:the average duration of operation was (95.8±18.0) min for HF group, and (97.8±19.1) min for LSJ group, there was no statistical signiifcance (P=0.363). Postoperative volume of drainage on the ifrst postoperative day was (35.2±20.3) mL for HF group, and (36.3±23.8) mL for LSJ group, there was no statistical signiifcance (P=0.977). One patient (1.0%) had temporary vocal cord paralysis in HF and one had postoperative hematoma (1.0%) in LSJ group. Temporary hypo-parathyroidism was detected in 18 patients (18.0%) of HF group, and 16 patients (15.4%) of LSJ group. The decline of parathyroid hormone during the ifrst postoperative day was (12.3±12.8) pg/mL in HF group, and (13.9±13.4) pg/mL in LSJ group. The decline of serum calcium was (0.20±0.13) mg/dL in HF group, and (0.20±0.16) mg/dL in LSJ group. There were all no statistical signiifcances (P>0.05).Conclusion:Both HF and LSJ are safe and effective in open thy-roidectomy without similar operative complications.

Hemorroidectomía con ligasure®: ¿mejoran el tiempo quirúrgico y la evolución postoperatoría? Comparación de los resultados con la cirugía clásica / Hemorrhoidectomy with ligasure®: do they improve surgical time and postoperative evolution? Comparison of the results with classical surgery

INTRODUCCIÓN: La hemorroidectomía es un procedimiento muy frecuentemente utilizado en la práctica diaria del coloproctólogo. Distintas técnicas fueron propuestas. Las más utilizadas son las abiertas (MilliganMorgan) o las cerradas (Ferguson). Iniciamos en 2010 nuestra experiencia utilizando el Ligasure® con una pinza especialmente diseñada a tal efecto. Los buenos resultados iniciales obtenidos nos motivaron a evaluar objetivamente esta técnica. OBJETIVO: Comparar los resultados de las hemorroidectomías utilizando el Ligasure® y los obtenidos con la clásica cirugía de Milligan-Morgan. DISEÑO: Retrospectivo sobre una base de datos de pacientes prospectiva. PACIENTES Y MÉTODO: Se evaluaron 230 pacientes operados consecutivamente entre enero de 2011 y diciembre de 2014 con el uso del Ligasure®. Estos resultados se compararon con los de otro grupo de 230 pacientes operados previamente con la técnica clásica de hemorroidectomía abierta (grupo control). El seguimiento mínimo fue de 6 meses para todos los pacientes...

BACKGROUND: Hemorrhoidectomy is daily performed in colorectal practice. Open and closed procedures has been described. In 2010 we start to perform hemorrhoidectomy with the use of the Ligasure® with a special device. The results obtained were the base to start a comparison with our standard technique. OBJECTIVE: To compare results between Ligasure® hemorrhoidectomies and classical surgical hemorrhoidectomies (control group). DESIGN: Restrospective comparison with prospective data. PATIENTS AND METHOD: Results of 230 consecutive patients operated on with the Ligasure® were compared with similar series of 230 patients operated with classical open technique. Follow-up was at least 6 months in both groups...

Clinical analysis of laparoscopic splenectomy in 31 cases / 重庆医学

Objective To study the surgical techniques and clinical experience of the total laparoscopic splenectomy .Methods Retrospective analysis 31 cases were performed laparoscopic splenectomy from January 2003 to April 2015 .Among them ,there were 12 cases with liver cirrhosis and hypersplenism ,5 cases with spleen hemangiomatosis ,3 cases with splenic lymphoma ,3 cases with splenic cyst ,2 cases with obsolete rupture of spleen hematoma ,6 cases with idiopathic thrombocytopenia .During surgery ,Li‐gaSure was used to deal with stomach ligament splenic artery .Using silk or endoscopic linear cutters to process splenic pedicle indi‐vidually .Results All operations were performed successfully without conversion to open surgery .13 patients were cutting off splenic pedicle by ligating of splenic portal blood vessel and 18 patients were using endoscopic linear cutters .The operation time was 80-240 min ,mean (130 ± 35)min ,the blood loss was 60-500 mL ,mean (150 ± 80)mL ,hospital stay was 8 .3 days .There was no mortality and pancreatic leakage complications .Conclusion On the basis of open surgery ,evaluating carefully before operation ,se‐lecting appropriate cases ,using different laparoscopic instruments ,handling splenic pedicle individually ,can make the laparoscopic splenectomy be a more safe and useful operation modality .

Contrast analysis of Milligan-Morgan and Ligasure mixed hemorrhoids surgery under local anesthesia / 重庆医学

Objective To investigate the clinical curative effect of Milligan‐Morgan and Ligasure blood vessels closed system for conducting mixed hemorrhoidectomy under local anesthesia .Methods 68 inpatients with mixed hemorrhoid in the general sur‐gery department of our hospital from April 2009 to April 2012 were selected and randomly divided into the Ligasure group (observa‐tion group ,34 cases) and the Milligan‐Morgan group (control group ,34 cases) .The operation adopted the local infiltration anesthe‐sia .The postoperative followed up lasted for 6‐36 months .The operation time ,intraoperative blood loss ,total hospitalization cost , postoperative hospital stay time ,postoperative pain degree and the postoperative complications were compared between the two groups .Results The average operation time in the control group and the observation group was (32 .35 ± 10 .24)min and (20 .29 ± 7 .88) min(P=0 .000) ,the average intraoperative blood loss was (29 .71 ± 14 .67)mL and (4 .97 ± 2 .89) mL(P=0 .000) ,the aver‐age postoperative pain score was (5 .88 ± 1 .12) points and (3 .47 ± 0 .83) points(P=0 .000) ,the average postoperative hospital stay time was (7 .97 ± 2 .55) d and (2 .29 ± 1 .17) d(P=0 .000) ,and the average hospitalization expense was (1 541 .32 ± 205 .91) Yuan and (2 872 .32 ± 652 .30) Yuan ,respectively ,the differences between the two groups were statistically significant (P=0 .000) .Dur‐ing the hospitalization period and follow‐up ,the anal exudation rate and the average postoperative pain score in the control group were higher than those in the observation group(P=0 .000) ,the occurrence rate of other complications had no statistically signifi‐cant differences between the two groups .Conclusion The Ligasure operation mode has less intraoperative blood loss ,shorter opera‐tion time and shorter postoperative hospital stay time .

Analysis on contrast application of different instruments in open thyroid operation / 重庆医学

Objective To compare the clinical therapeutic effect of LigaSure vessel sealing system ,ultrasonic scalpel and mo‐nopolar high frequency electrocautery in open thyroid operation .Methods 293 cases of thyroid operation sequentially admitted in our hospital and in accordance with the inclusion criteria were collected and divided into three groups by the method of random dig ‐its table .There were 98 cases in the LigaSure vessel sealing system group (L‐Sure group) ,100 cases in the ultrasonic scalpel (US group) and 95 cases in the monopolar high frequency electrocautery (M‐E group) .The intraoperative and postoperative conditions were compared among 3 groups .Results The operation time ,intraoperative amount of bleeding and postoperative drainage in the L‐S group and the US group were significantly less than those in the M‐E group (P0 .05) .Conclusion The LigaSure vessel sealing system and ultrasonic scalpel can shorten the operation time ,reduce the amount of bleeding and postoperative drainage ,relieve pain and reduce the hospitalization duration .

Comparación de sistema de sellado de vasos y ligadura convencional en tiroidectomías / Comparison of vessel sealing system and conventional ligation in thyroidectomy

Cada día es más frecuente en la cirugia tiroidea, el uso de sistemas electromecánicos como método hemostático, en oposicion a la hemostasia convencional. Se realiza un estudio comparativo entre el sistema de sellado de vasos sanguíneos LigaSure® y la hemostasia convencional con ligadura. Se analizaron 113 historias de pacientes sometidos a cirugia tiroidea, evaluando estudios preoperatorios, indicación quirúrgica, complicaciones intra y postoperatorias, reintervención, tiempo quirúrgico, días de hospitalización y resultados de anatomía patológica. Entre enero 2002 y diciembre del 2012, se realizaron 113 tiroidectomías; 52 con el método habitual de ligadura y en 61 pacientes se utilizó como método hemostático el LigaSure®. El promedio de edad fue de 41,3 y 46 años respectivamente; el diagnóstico fue de carcinoma papilar en 19,2% y 22,9%. El tiempo de duración del acto quirúrgico en el grupo de hemostasia convencional fue de 78,8 minutos y en el grupo con sellado de vaso de 74,4 minutos, con un drenaje postoperatorio de 85 y 71 cc para cada grupo. Los días de hospitalizacion fue 3,1 y 2,19. En cuanto a complicaciones: el hematoma post operatorio, con reintervencion (2 casos en ligadura convencional, 1 con el LigaSure®); lesión del nervio recurrente laríngeo (1 caso en cada grupo), hipocalcemia transitoria (3 casos en el grupo convencional y 1 caso en el grupo de LigaSure®); un paciente ameritó traqueostomía en el grupo de LigaSure®. En conclusión, la hemostasia en la tiroidectomía utilizando el metodo de sellado de vasos con LigaSure®, permite la realización del acto quirurgico con comodidad y seguridad, con una ligera ventaja que al utilizar métodos convencionales.

Every day, it is more common in thyroid surgery, the use of electromechanical systems, as hemostatic method in thyroid surgery, as opposed to conventional hemostasis. A comparative study between blood vessel sealing system LigaSure® and conventional hemostasis with ligation was carried out. 113 patients records who underwent thyroid surgery, evaluating preoperative studies, surgical indication, intra and postoperative complications, reoperation, surgical time, days of hospitalization and pathological anatomy results were analized. Between january 2002 and december 2012, 113 thyroidectomies were performed; 52 with the usual ligature method and 61 patients with the LigaSure® hemostatic method. The average age was 41.3 and 46 years respectively; papillary carcinoma was diagnosed in 19,2% and 22,9%. The duration of surgery in the conventional hemostasis group was 78.8 minutes and 74.4 minutes in the vessel sealing group, with a postoperative drainage of 85 and 71 cc for each group. The days of hospitalization were 3.1 and 2.19. In terms of complications: postoperative hematoma with reoperation (2 cases in the conventional group and 1 case in the LigaSure® group); recurrent laryngeal nerve lesion (1 case in each group), transient hypocalcemia (3 cases in the conventional group and 1 case in the LigaSure® group); one patient required tracheostomy in the LigaSure® group. In conclusion, hemostasis in thyroidectomy using the LigaSure® vessel sealing method, allows the realization of surgery in comfort and safety with a slight advantage to conventional methods.

Prevention of lymphocele development in gynecologic cancers by the electrothermal bipolar vessel sealing device / 부인종양

OBJECTIVE: A number of new techniques have been developed to prevent lymphocele formation after pelvic lymphadenectomy in gynecologic cancers. We assessed whether the electrothermal bipolar vessel sealing device (EBVSD) could decrease the incidence of postoperative lymphocele secondary to pelvic lymphadenectomy. METHODS: A total of 321 patients with gynecologic cancer underwent pelvic lymphadenectomy from 2005 to 2011. Pelvic lymphadenectomy without EBVSD was performed in 134 patients, and pelvic lymphadenectomy with EBVSD was performed in 187 patients. We retrospectively compared the incidence of lymphocele and symptoms between both groups. RESULTS: Four to 8 weeks after operation, 108 cases of lymphocele (34%) were detected by computed tomography scan examination. The incidence of lymphocele after pelvic lymphadenectomy was 56% (75/134) in the tie ligation group, and 18% (33/187) in the EBVSD group. We found a statistically significant difference in the incidence of lymphocele between both groups (p<0.01). To detect the independent risk factor for lymphocele development, we performed multivariate analysis with logistic regression for three variables (device, number of dissected lymph nodes, and operation time). Among these variables, we found a significant difference (p<0.001) for only one device. CONCLUSION: Use of the EBVSD during gynecological cancer operation is useful for preventing the development of lymphocele secondary to pelvic lymphadenectomy.

Eficacia de la pinza Ligasure comparado con la técnica tradicional para la histerectomía abdominal total en pacientes atendidas en el Hospital Nacional Docente Madre Niño San Bartolomé: 2011-2012 / Effectiveness of the Ligasure clamp compared with the traditional technique for total abdominal hysterectomy in patients treated at the Teaching National Hospital Mother Child San Bartolome: 2011-2012

OBJETIVO: Determinar si la técnica de sellado de vasos mediante la pinza Ligasure es más efectivo que la técnica tradicional para la Histerectomía abdominal total, en pacientes atendidas en el Hospital Nacional Docente Madre Niño San Bartolomé durante el periodo de 2011-2012. METODOLOGIA: Estudio observacional, analítico comparativo, de corte transversal, retrospectivo. Se trabajó con un total de 114 pacientes sometidas a histerectomía abdominal total atendidas en Hospital Nacional Madre Niño San Bartolomé, de las cuales a 38 se les realizó la Técnica Ligasure y a 76 se les realizó la Técnica Convencional. Las fuentes de información son las historias clínicas de aquellas pacientes que acudan al Hospital San Bartolomé durante el año 2011 hasta el 2012. Para el análisis descriptivo se determinaron medidas de tendencia central y dispersión así como para variables cualitativas se determinaron frecuencias y porcentajes. Para el grado de asociación se utilizó la prueba Chi-cuadrado, con un nivel de confianza (lC) del 95 por ciento. Se consideró significativo un valor p<=0.05. RESULTADOS: La edad promedio de las pacientes fue 49.2 años, con rangos de edad entre 41 a 60 años (68.4 por ciento), siendo la mayoría de nivel Secundario (50 por ciento). Entre las características sociodemográficas: El grado de instrucción no se relaciona con la técnica utilizada (Ligasure y Convencional) para histerectomía abdominal, mientras que la edad (p=0.001) y la ocupación (p<0.001) si se relacionan con la técnica utilizada. Al analizar la paridad, el número de partos a término (p=0.016) y de hijos vivos (p=0.035) se relacionan con la técnica utilizada (Ligasure y Convencional) para histerectomía abdominal. Respecto a las cirugías abdominales anteriores, se observa que existe relación entre las principales cirugías abdominales y la técnica utilizada (Ligasure y Convencional) (p=0.026). Además existe relación entre los antecedentes personales de patología uterina y el tipo de técnica...

OBJECTIVE: To determine whether the technique of vessel selling by the clamp Ligasure is more effective than the traditional technique for total abdominal hysterectomy, in patients treated at the Teaching National Hospital Child Mother San Bartolome during the period 2011-2012. METHODOLOGY: Observational study comparative analytical, cross-sectional, retrospective. We worked with a total of 114 patients submitted to total abdominal hysterectomy treated at the Teaching National Hospital Child Mother San Bartolome; of which 38 were performed technical Ligasure and 76 were performed conventional technique. The sources of information are the c1inical records of those patients who come to National Hospital San Bartolome during 2011 to 2012. For the degree of association was used Chi-square test, with a confidence level (CI) of 95 per cent. P value<=0.05 was considered significant. RESULTS: The average age of the patients was 49.2 years, with range in age between 41-60 years (68.4 per cent), the majority of Secondary level (50 per cent). Among the sociodemographic characteristics: The level of education is not related to the technique used (Ligasure and Conventional) for abdominal hysterectomy, while the age (p=0.001) and occupation (p<0.001) are related to the technique used. Analyzing the parity, number of births at term (p=0.016) and the live children (p=0.035) are related to the technique used (Ligasure and Conventional) for abdominal hysterectomy. Regard to previous abdominal surgeries, it is observed that there is a relationship between the main abdominal surgery and the technique used (Ligasure and Conventional) (p=0.026). In addition there is a relationship between the personal history of uterine pathology and the type of technique used (Ligasure and conventional) for abdominal hysterectomy (p<0.001). The type of technique used in 66.7 per cent of patients undergoing abdominal hysterectomy was the conventional technique and the technique was 33.3 per cent...

Effectiveness of the EnSeal(TM) System in Colorectal Cancer Surgery: A Pilot Randomized Study for Comparison with LigaSure(TM)

PURPOSE: Use of bipolar electocoagulation devices becomes popular in the laparoscopic surgical field. However, several studies comparing energy-based devices for use in performance of mechanical sealing and cutting techniques have reported various results. The aim of this study was to evaluate feasibility and efficacy of new commercially available bipolar electocoagulation devices: EnSeal(TM) device (Ethicon Endo-Surgery, Cincinnati, OH, USA) by comparison with LigaSure(TM) atlas 5 mm (COVIDIEN, Boulder, CO, USA), for use in performance of coagulation and cutting techniques during performance of laparoscopic colorectal cancer surgery. METHODS: Between June 2010 and February 2011, 50 consecutive patients who underwent curative laparoscopic surgery for right colon cancer or rectal cancer were enrolled. Time and number of device activations were compared during omentectomy in cases of right colectomy and mesorectal trimming procedure in cases of anterior resection. Pathologic data and short-term clinical outcomes were also compared. RESULTS: No significant differences in terms of clinicopathologic comparison were observed between the EnSeal and LigaSure groups. No significant difference in mean operative time (207.6+/-45.3 vs. 198.9+/-57.2; p=0.558), mean time of omentectomy (11.0+/-4.5 vs. 12.6+/-8.6; p=0.293), mean time of m esorectal trimming (18.6+/-10.0 vs. 16.1+/-6.9; p=0.418), mean number of device activations during omentectomy (43.5+/-10.2 vs. 51.6+/-39.2; p=0.586), and mean number of device activations during performance of mesorectal trimming (44.8+/-22.3 vs. 49.1+/-23.7; p=0.597) were observed between the two groups. CONCLUSION: Bipolar electocoagulation devices were adapted for use in laparoscopic surgery, resulting in reduced operative time and blood loss. EnSeal(TM) Device and LigaSure(TM) atlas 5 mm were useful during performance of sealing and cutting techniques in laparoscopic colorectal cancer surgery.

Estudio comparativo entre hemorroidectomía cerrada de Ferguson y hemorroidectomía con LigaSure / Comparative study between the Ferguson closed hemorrhoidectomy and the LigaSure techniques

Introducción. El tratamiento quirúrgico de las hemorroides internas de grado IV y de casos seleccionados de hemorroides internas de grado III, es la hemorroidectomía. La percepción del paciente sobre esta operación es de temor a las complicaciones y al dolor posoperatorio. Se ha descrito el uso del instrumento LigaSure™ para el tratamiento de hemorroides internas de grados III y IV con excelentes resultados en términos de tiempo quirúrgico, dolor posoperatorio y recuperación precoz. Esta técnica ha sido comparada favorablemente con todas las técnicas conocidas en diversos estudios.Objetivo. Comparar la hemorroidectomía convencional, representada por la técnica de Ferguson y la hemorroidectomía con LigaSure™. Pacientes y métodos. Se estudió una muestra de conveniencia de 20 pacientes consecutivos con hemorroides de grados III y IV. El grupo control se operó mediante la técnica de Ferguson y el grupo de estudio se operó mediante la técnica con LigaSure™. Se describe e ilustra la técnica de la hemorroidectomía con LigaSure™. Resultados. El tiempo quirúrgico fue significativamente menor para el grupo de estudio comparado con el grupo control (13,9 ± 3,3 vs. 24,3 ± 7 minutos, p=0,04). Los resultados de todos los demás parámetros evaluados fueron similares en ambos grupos. En el seguimiento a dos años de la cirugía de los 20 pacientes, no se encontró recurrencia ni estenosis en ningún caso. Conclusiones. La hemorroidectomía con LigaSure™ reduce significativamente el tiempo quirúrgico, siendo comparable en términos de dolor posoperatorio y complicaciones a la hemorroidectomía de Ferguson.

Introduction. The surgical treatment of internal hemorrhoids grade IV and selected grade IIII hemorrhoids is hemorrhoidectomy. Patients´ perceptions regarding this procedure are fear of complications and postoperative pain. A novel technique using the LigaSure™ device for the surgical treatment of hemorrhoids has been described with excellent outcomes in terms of surgical time, postoperative pain and early recovery. This technique has been favorably compared to all of the other currently known techniques in many studies. Aim. To compare the conventional hemorrhoidectomy represented by the closed technique of Ferguson with the LigaSure™ hemorrhoidectomy. Patients and Method. A convenience sample of 20 consecutive patients with hemorrhoids grades III and IV was studied. The control group underwent closed Ferguson hemorrhoidectomy and the study group was operated on with the LigaSure™ technique. The LigaSure™ hemorrhoidectomy technique is described.Results. The surgical time was significantly reduced for the study group compared with the control group (13.9 ± 3.3 min versus 24.3 ± 7 min, p=0.04). All other parameters had similar results for both groups. At follow-up, 2 years after hemorrhoidectomy, we did not find any recurrence or stenosis in the 20 studied patients. Conclusions. The LigaSure™ hemorrhoidectomy significantly reduces the surgical time, being comparable in terms of postoperative pain and other complications to the Ferguson's open hemorrhoidectomy.

Clinical study of LigaSure vessel sealing system for surgery in gastroenteric cancer / 中国医师进修杂志

Objective To investigate the value of LigaSure vessel sealing system for surgery in gastroenteric cancer. Methods From January to September 2009,44 cases of gastroenteric cancer were operated by using LigaSure vessel sealing system,including 13 cases of gastric cancer, 14 cases of colon cancer, 17 cases of rectum cancer. Laparoscopy was employed in 10 cases. Results All the cases were performed successfully. The operation time was 130-250 min, the blood loss was 50-250 ml, and the number of lymph nodes resected was 4-20. None of the cases had serious complications. Conclusion As an optimal hemostatic tool, LigaSure vessel sealing system is safe and feasible for gastroenteric cancer.

Application of Ligasure vessel sealing system for resection of retroperitoneal tumor / 中国综合临床

Objective To explore the value of Ligasure vessel sealing system(LVSS)during resection of retroperitoneal tumor.Methods Group 1 including 32 cases were performed resection of retroperitoneal tumor with LVSS and electrosurgical seapel from Jun.2004 to Oct.2008.group 2 including 26 cases were done with electrosurgieal seapel from Jan.2001 to Jun.2004.Operating blood loss,operating time,iatrogenic injury,postoperative blood loss and hospital stay were compared between the two groups.Results There was no significant difference in hospital stay[(11.7±0.7)d vs.(12.3±1.4)d)]and iatrogenic injury(9.38%vs.16.00%)between two groups statistically(P＞0.05),but the intraoperative blood lose[(403.1±37.1)ml vs.(704.0±129.0)m1)s,postoperative blood loss[(131.5±18.4)ml vs.(214.8±29.2)ml)]and operating time[(166.5±8.9)min vs.(186.8±15.4)min]were less in group 1 than that in group 2(P＜0.05).Conclusion Ligasure vessel sealing system has advantages of safe coagulation,shortening operation time in resection of retroperitoneal tumor.

A Comparison of the Usefulness and Safety of the Harmonic™ Scalpel, Ligasure™ System, and Classic Clamp-and-Tie Technique for Hemostasis during Thyroid Surgery / 대한내분비외과학회지

PURPOSE: The aim of this study was to compare the outcome of total thyroidectomy performed with the Ligasure™ system, Harmonic™ scalpel, and the conventional clampand-tie technique. METHODS: Between November 2006 and July 2009, the data were retrospectively collected from 600 consecutive total thyroidectomies by one surgeon. All cases were divided into 3 groups based on the method of hemostasis: classic group patients (n=200) underwent total thyroidectomy with the conventional clamp-and-tie technique Ligasure group patients (n=200) underwent total thyroidectomy with the Ligasure™ system (electrothermal bipolar vessel sealing system) and the Harmonic group patients (n=200) underwent total thyroidectomy with a Harmonic™ scalpel (ultrasonic cutting and coagulating surgical device). We compared the clinical outcomes with respect to the operative time, amount and duration of drainage, hospital stay, and post-operative complications. RESULTS: The three groups were similar with respect to clinical and demographic characteristics, with the exception of invasiveness. The mean operative time of the Harmonic group was significantly shorter than the other 2 groups (P<0.001) specifically, 75 min in the Harmonic group, 87 min in the Ligasure group, and 120 min in the classic group. The amount of drainage in the Harmonic group was greater than the other groups (P<0.001). Similarly, the duration of drainage and hospital stay of the Harmonic group were longer than the other groups. There was no significant difference in the incidence of complications between the three groups. CONCLUSION: Hemostasis during thyroidectomy by the Harmonic™ scalpel or Ligasure™ system was safe and timesaving. Therefore, the Harmonic™ scalpel and Ligasure™ system will be available for thyroid surgery as alternative techniques for the clamp-and-tie technique.

A Comparison of Conventional Thyroidectomy and LVSS Thyroidectomy: The Feasibility of the LVSS in the Thyroid Operation

PURPOSE: Recently, Ligasure vessel sealing system (LVSS) is being introduced in thyroid operations. In this study, we compare the clinical outcomes of LVSS using thyroidectomy with those of conventional thyroidectomy. METHODS: From Nov 2006 to Oct 2008, 400 patients managed with total thyroidectomy were investigated. Half of them (the conventional group) were operated on with conventional methods, whereas another half (the LVSS group) were operated on using LVSS. Operation time, amount of drainage, duration of drainage, hospital stay, and complications (numbness, hoarseness, hematoma) of the two groups were compared. RESULTS: The mean operation time of the LVSS group was 87.53+/-27.49 (min), and that of the conventional group was 120.48+/-39.51 (min). Therefore, operation times of the LVSS group was significantly shorter than that of the conventional group (P<0.001). But, there was no significant difference in the amount of drainage, duration of drainage, duration of hospital stay, and the incidences of complications. CONCLUSION: Our studies show the effectiveness and safety of LVSS in thyroid operations. We advocate the application of LVSS to thyroid operations.

Comparative analysis of ligasure vessel sealing system and bipolar electric coagulation in the laparoscopic hysterectomy / 中国基层医药

Objective To investigate the clinical value of different treatments of uterine artery and vein in laparoscopic hysterectomy. Methods In 184 patients accepting lapaxoscopie hysterectomy, ligasttre vessel sealing system ,was applied to uterine vessels, while bipolar electric coagulation to coagulate the uterine vessels during the operation. Results Among the groups, women undergoing ligasure hand the smaller amount of estimated blood loss and was associated with shorter operating time, there were statistically significant differences among the two groups( P＜0.01). Conclusion Each of the two operative ways is feasible or laparoacopic hysterectomy. The way of dissociating uteri arteriovenous completely before they were cut off with ligasure in laparoscopic panhysterectomy has many important clinical value such as easy appliance, safety, convenient operation, clear operation field and so on.

Application of LigaSure vessel sealing system in laparoscopic nephrectomy / 中华泌尿外科杂志

Objective To explore the value of the LigaSure vessel sealing in laparoscopic nephrectomy surgery. Methods Laparoscopic nephreetomies were performed in 41 cases from May 2004 to December 2006 by using LigaSure, including simple nephrectomies, radical nephrectomies and nephroureterectomies. The operative time, estimated blood loss, open conversion rate, duration of postoperative drainage, total amount of postoperative drainage, postoperative hospital day as well as complication rate were recorded and analyzed retrospectively. Results All procedures were finished successfully without conversion to open surgery. No severe vascular complication or other serious complications happened. The mean operative time was 146min (range, 35-240 min) ; mean blood loss was 163ml (range, 30-450 ml); mean time for postoperative drainage was 3d (range, 1-6 d) ; mean amount of postoperative drainage was 229ml (range, 45-435 ml). The postoperative hospital staying was 6-21 d, with the average of 10 days. Conclusions The LigaSure vessel sealing system produees a consistent, reliable, permanent seal of veins, arteries, and tissue bundles. It could decrease operative time and blood loss. This new energy-based vessel-ligation device appears to be effective in advanced laparoscopic procedures.