Comparison of Vessel Sealing Systems with Conventional

Abstract

BackgroundHaemorrhoids are cushions of submucosal vascular tissue located in the anal canal starting just distal to the dentate line. Haemorrhoidal disease is a common anorectal disorder which has symptoms of bleeding, prolapse, pain, thrombosis, mucus discharge, and pruritus. Haemorrhoidectomy is one of most frequently performed anorectal operation worldwide.ObjectivesThe aim of this study was to compare the effectiveness of the LigaSure tissue sealing device, Harmonic Scalpel and conventional MM open haemorrhoidectomy.Materials and MethodsSixty-nine patients with newly diagnosed symptomatic grade three or grade four haemorrhoidal disease, from July 2011 to December 2011 were recruited for the study. Patients were prospectively randomized to LigaSure, Harmonic Scalpel and conventional haemorrhoidectomy. Patients were evaluated on the basis of the mean operative time, postoperative pain, day of discharge, early and late complications.ResultsEach group has twenty-three patients. Ten (14.5 %) were female and fifty-nine (85.5 %) were male. Mean age were 44.5 ± 10.8 for LigaSure group, 39.5±14.4 for Harmonic Scalpel group and 39.8 ± 13.6 for conventional haemorrhoidectomy group. Mean operative time was 12.6 ± 2.9 for LigaSure group, 12.6 ± 2.5 for Harmonic Scalpel group and 22.3 ± 4.5 for conventional haemorrhoidectomy group. Postoperative pain and required analgesic dose were significantly lower for conventional haemorrhoidectomy. Wound healing was also more rapid in conventional haemorrhoidectomy than both LigaSure and Harmonic Scalpel.ConclusionsLateral heat dissipation of energy based cautery such as Harmonel Scalpel and LigaSure is considerably high when compared with conventional methods. More thermal damage which is generated on tissue seems to be the reason for increased degree of postoperative pain and delay in wound healing.

Harmonic Scalpel and Electrothermal Bipolar Vessel Sealing System in Head and Neck Surgery

“…In fact, thermal damage to tissue seems to be the reason for increased postoperative pain and delay in wound healing. 15,16 In this study we investigated 2 of the most common newgeneration scalpels in head and neck surgery-that is, EBVS and HS-from the point of view of thermal spread in tissues and the consequent histological injury to nerves. The aim was to suggest a safer utilization of each device and to propose a "safety limit" from nerves, which are crucial structures in ENT surgery and in particular in neck dissection, parotid surgery, and thyroid surgery.…”

Comparison of the reliability and efficacy of LigaSure hemorrhoidectomy and a conventional Milligan-Morgan hemorrhoidectomy in the surgical treatment of grade 3 and 4 hemorrhoids

“…According to a study by Peker et al, (12) in the LigaSure group, operation and return to work times were shorter than in the conventional group, while hospitalization and complication rates were similar. In a meta-analysis by Mastakov et al (11) on 11 studies with 1,046 patients, in patients who underwent LigaSure operations, almost all outcome parameters were better than those of the conventional group except complications.…”

“…This advantage enables rapid dissection of hemorrhoids without blood. Comparative studies of LigaSure with conventional methods can be found in the literature (7,12).…”

A Prospective Comparative Study: Stapler Hemorrhoidopexy vs Laser Hemorrhoidoplasty in the Treatment of Hemorrhoids

“…Other forms of hemorrhoidal coagulation have been attempted by several authors such as LigaSure system, Harmonic Scalpel, electrothermal coagulation. Peker et al [24] studied 69 patients randomized to LigaSure, Harmonic Scalpel and conventional hemorrhoidectomy. They observed that the postoperative pain and analgesic requirement was much higher in LigaSure and Harmonic Scalpel group.…”