Laparoscopic splenectomy using ligasure

Romano, Fabrizio; Caprotti, Roberto; Franciosi, Chiara; Fina, Sergio De; Colombo, Giovanni; Uggeri, Franco

doi:10.1007/s00464-001-9145-z

Cited by 108 publications

(92 citation statements)

References 22 publications

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“…11 Recently, LS has been increasingly indicated for splenomegaly, owing to advances in laparoscopic devices such as harmonic scalpel, ligasure vessel sealing system and endoscopic vascular stapler, and improvements in surgical procedures. [12][13][14][15][16] It has been reported that LS was feasible and is associated with a lower morbidity and shorter hospital stay than OS in patients with splenomegaly. 17,18 The indications for LS and LS with devascularization (LSD) have also been extended to patients with liver cirrhosis.…”

Section: Introductionmentioning

confidence: 99%

Laparoscopic splenectomy with or without devascularization of the stomach for liver cirrhosis and portal hypertension: a systematic review

Chen

Yang

et al. 2012

ANZ Journal of Surgery

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Background: Open splenectomy and devascularization are effective treatments for cirrhotic patients with severe thrombocytopenia and variceal bleeding. However, it remains controversial whether laparoscopic splenectomy (LS) and devascularization (LSD) can be indicated and beneficial in these patients. Objectives: A systematic review of the efficacy and safety of LS and LSD for patients with liver cirrhosis and portal hypertension was undertaken to clarify controversy about their utilization in such patients. Methods: A systematic search strategy was performed to retrieve relevant studies from PubMed and Embase.com. The literature search and data extraction were independently performed by two reviewers. Results: Sixteen articles met the inclusion criteria. The methodology of the identified articles was poor. Six hundred and fifty-one patients, including 478 LS patients and 173 LSD patients, were involved in efficacy and safety evaluations. There was wide variability in the outcome measures between studies. There was only one death in the patients underwent LSD. Reported major complications included post-operative bleeding requiring re-surgery, pancreatic leakage and gastric perforation. Seven studies were identified with comparisons between laparoscopic and open procedures. No meta-analysis was possible because of heterogeneity between studies and lack of randomization. Conclusions: The publications reviewed revealed LS and LSD to be safe and effective in the setting of liver cirrhosis and portal hypertension. From the comparison articles, laparoscopic procedures appear to be superior to open procedures regarding blood loss, hospital stay, complication rate and liver function impairment. However, it is difficult to draw firm statistical conclusions due to lack of high-quality evidence.

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Section: Introductionmentioning

confidence: 99%

Laparoscopic splenectomy with or without devascularization of the stomach for liver cirrhosis and portal hypertension: a systematic review

Chen

Yang

et al. 2012

ANZ Journal of Surgery

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“…Vessels sealed in this manner have demonstrated clinically equivalent bursting pressures when compared with vascular staples, titanium clips, and sutures, and significantly higher pressures when compared with the harmonic scalpel in vessels in 4-7 milimeter (mm) diameter range. [25][26][27] Romano and coworkers [28] reported success using the LigaSure Vessel Sealing System (Valleylab) in performing laparoscopic splenectomy. Similarly head and neck surgeons have demonstrated a reduced operative time and blood loss during thyroidectomy using the ligasure vessel sealing system.…”

Section: Discussionmentioning

confidence: 99%

Electrocautery versus Scalpel Incision in Open Cholecystectomy: A Randomised Prospective Study

Dhiman¹,

Sharma²,

Abrol³

et al. 2017

AIMDR

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Background: The electrocautery was used to fulgurate tumours in the past untill 1926 when Cushing introduced it for use in neurosurgery.The use of electrocautery in skin incisions has been discouraged in the past mianly because of undue fear of cutaneous scarring, wound dehiscence and infection. Several reports reflected the recent change in this concept. A reduced postoperative pain has been reported in patients undergoing cholecystectomy when abdominal incision was given with diathermy than when it was created with scalpel. Methods: This was an institution based prospective cohort study conducted in department of surgery at DRPGMC TANDA from January to December 2013.Hundred patients undergoing elective open cholecystectomy were included and divided into two groups through convenience sampling after informed consent was taken. They were allocated to one of the intervention method using block randomization method.In group A, 50 cases were included in which skin incision was given with scalpel.In group B, another 50 cases were included in which skin incision was given with electrocautery. Results: The parameters studied were post operative pain and wound infection.Post operative pain was recorded according to visual analog scale at 6th, 18th and 24th hour.Wound infection was recorded as per Southompton wound scoring system on 2nd,8th,14th & 30th post operative day.Visual analogue score was more in early postoperative period in young as well as elderly patients in both the groups but not statistically significant (P=0.60).On comparison among both sexes between two groups, Southampton Wound Score was same at 2nd ,8th ,14th and 30th day among both the sexes. Conclusion: Number of studies have shown that post operative pain as well as infection rate are not increased when electrocautery is used to make the skin incisions. Similarly we also support the view that use of elctrocautery is safe and it's use for making skin incisions in elective open cholecystectomy doesnot increase the rate of post operative pain or wound infections.

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“…[16,17] As mentioned above, in a series of LA in which the LigaSure ® device was used the reported operation times were between 57 to 123 minutes and mean sizes of the adrenal masses were between 40 to 62 mm. [13][14][15] In the present study, the mean operation time and mean size of the adrenal masses in the LigaSure ® device group were 90.2 (range; 50 to 150) minutes and 37.2 (range; 15 to 72) mm, respectively.…”

Section: Discussionmentioning

confidence: 99%

Comparison of adrenal vein control methods in laparoscopic adrenalectomy

Arslan¹

2017

Laparosc Endosc Surg Sci

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Laparoscopic splenectomy using ligasure

Abstract: The use of Ligasure, associated with the lateral position, results in a gain of time and safety. Furthermore, the average intraoperative bleeding of this series is very low.

Cited by 108 publications

References 22 publications

Laparoscopic splenectomy with or without devascularization of the stomach for liver cirrhosis and portal hypertension: a systematic review

Laparoscopic splenectomy with or without devascularization of the stomach for liver cirrhosis and portal hypertension: a systematic review

Electrocautery versus Scalpel Incision in Open Cholecystectomy: A Randomised Prospective Study

Comparison of adrenal vein control methods in laparoscopic adrenalectomy

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