Advanced Sealing and Dissecting Devices in Laparoscopic Adrenal Surgery

Solaini, Leonardo; Arru, Luca; Merigo, Giulia; Tomasoni, Matteo; Gheza, Federico; Tiberio, Guido Alberto Massimo

doi:10.4293/108680813x13693422520350

Cited by 8 publications

(10 citation statements)

References 13 publications

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“…In addition, conversion rates and intraoperative and postoperative complication rates in laparoscopic adrenalectomy did not differ in both devices [60].…”

Section: ) Electrothermal Monopolar Vessel Sealing Vs Ligasurementioning

confidence: 82%

Era of Bloodless Surgery: Spotlights on Hemostasic Materials and Techniques

Park

Koh

2018

Hanyang Med Rev

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“…In addition, conversion rates and intraoperative and postoperative complication rates in laparoscopic adrenalectomy did not differ in both devices [60].…”

Section: ) Electrothermal Monopolar Vessel Sealing Vs Ligasurementioning

confidence: 82%

Era of Bloodless Surgery: Spotlights on Hemostasic Materials and Techniques

Park

Koh

2018

Hanyang Med Rev

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“…In fact, many papers have been published in last decade with this debated topic, but few data are available concerning the impact of these instruments on laparoscopic adrenalectomy. Same Authors describe personal experiences with one device [23], other ones compare results between LS and HS or between these two devices with electric hook (14,15,18,24) but no papers analyze and compare the use of these three technologies.…”

Section: Discussionmentioning

confidence: 99%

“…However, this study has some limitations represented by the retrospective analysis and the bias belonging from groups not well matched. [14,15,24] To the best of our knowledge, the current study is the first comparing all commercially available advanced energy devices in laparoscopic adrenal surgery.…”

Section: Discussionmentioning

confidence: 99%

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The impact of the ultrasonic, bipolar and integrated energy devices in the adrenal gland surgery: literature review and our experience

et al. 2019

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Background: The gold standard approach for surgical treatment of benign and malignant adrenal lesion is considered the laparoscopic one, due to a lot of advantages compared to open approach. The rapid propagation of this surgical technique is due to the diffusion of haemostatic devices in laparoscopic adrenal surgery. The principal aim of this study is to analyze the outcome of LA using each energy modality, evaluating the eventual superiority of an instrument over the others. Methods: A retrospective study, involving 75 consecutive patients submitted to LA by transperitoneal lateral approach from January 2013 to June 2017, was performed. Age less than 70 years old, adrenal adenomas less than 8 cm in diameter, incidentalomas < 6 cm, myelolipomas < 13 cm, adrenal metastases < 7 cm and ASA score ≤ III were the main surgical inclusion criteria. All involved patients were divided into three group, one for each energy device: group 1-Harmonic Scalpel, group 2-Ligasure vessel sealing system and group 3-Thunderbeat. In each group only one device was applied for dissection and haemostasis during the whole operation. Each group consisted of 25 patients, well matched for histology, tumor size and site, gender and age. The following parameters were collected: age, gender, size of the tumor, side of the affected gland, pathology, operating time, intraoperative blood losses, hospitalization time, complication and conversion rate. Results: There was no significant statistical difference between groups regarding the relationship between male/ female, right site/left site, the mean age, hospitalization time and the tumor size (p > 0.05). Significant statistical difference are detectable in operation time and intraoperative blood losses. Thunderbeat, compared respectively with Ligasure and Harmonic Scalpel, is the fastest device (p < 0,001). The second faster device resulted Harmonic Scalpel, which meanly reduced the operation time compared to Ligasure (p = 0.048). intraoperative blood losses are reduced using Thunderbeat (p < 0,001) and HS (p = 0.006) compared to Ligasure, but between Thunderbeat and Harmonic Scalpel there isn't significant statistical difference (p = 0.178).

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“…Advanced bipolar devices, such as LigaSure® (Medtronic Minimally Invasive Therapies, USA), BiCision® (ERBE Elektromedizin GmbH, Germany), and EnSeal® (Ethicon EndoSurgery Inc., USA), pro vide active feedback control of the applied energy out put 27 . Consequently, production of heat in the tissue can be kept below 100 °C.…”

Section: Key Pointsmentioning

confidence: 99%

Advances in laparoscopic surgery in urology

Rassweiler

Teber

2016

Nat Rev Urol

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In the past 10 years, laparoscopy has been challenged by robotic surgery; nevertheless, laparoscopic techniques are subject to continuous change. Ultrahigh definition is the next development in video technology, it delivers fourfold more detail than full high definition resulting in improved fine detail, increased texture, and an almost photographic emulsion of smoothness of the image. New 4K ultrahigh-definition technology might remove the current need for the use of polarized glasses. New devices for laparoscopy include advanced sealing devices, instruments with six degrees of freedom, ergonomic platforms with armrests and a chest support, and camera holders. A manually manipulated robot-like device is still at the experimental stage. Robot-assisted surgery has substantially revolutionized laparoscopy, increasing its distribution; however, robot-assisted surgery is associated with considerable costs. All technical improvements of laparoscopic surgery are extremely valuable to further simplify the use of classical laparoscopy.

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Advanced Sealing and Dissecting Devices in Laparoscopic Adrenal Surgery

Abstract: The use of advanced sealing devices was associated with reduced operative time, particularly with left adrenalectomy.

Cited by 8 publications

References 13 publications

Era of Bloodless Surgery: Spotlights on Hemostasic Materials and Techniques

Era of Bloodless Surgery: Spotlights on Hemostasic Materials and Techniques

The impact of the ultrasonic, bipolar and integrated energy devices in the adrenal gland surgery: literature review and our experience

Advances in laparoscopic surgery in urology

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