Ultrasonic Dissection versus Conventional Dissection for Pancreatic Surgery: A Meta-Analysis

Abstract

Background. The role of ultrasonic dissection (UD) in pancreatic surgery remains controversial. The aim of this meta-analysis was to evaluate the clinical effect of UD in pancreatic surgery when compared with conventional dissection (CD). Materials and Methods. A comprehensive literature search was performed to identify eligible studies that compared UD with CD for pancreatic surgery in PubMed, EMBASE, Web of Science, and the Cochrane Library. Risk ratio (RR) or mean difference with 95% confidence interval (CI) was calculated. Results. Six studies were included with a total of 215 patients undergoing UD and 210 undergoing CD. In comparison with CD in distal pancreatectomy, UD was associated with lower rates of pancreatic fistula (RR = 0.46, 95% CI: 0.27–0.76) and abdominal abscess and shorter operation time and hospital stay (P < 0.05). In pancreaticoduodenectomy, there was no significant difference in pancreatic fistula rate between two groups (RR = 0.79, 95% CI: 0.48–1.29). However, the significantly less intraoperative blood loss and the transfused blood unit were found in patients receiving UD (P < 0.05). Conclusions. The results of this meta-analysis show that, in comparison with CD, UD is associated with better perioperative outcomes in pancreatic surgery.

Superior Dissecting Capability of A New Ultrasonic Device Improves Efficiency and Reduces Adhesion Formation

“…Harmonic was regarded as superior to electrosurgery for axillary dissections, demonstrating shorter duration of drainage, lower rates of seroma formation and reduced numbness [4,5]. Likewise in pancreatic surgery, Harmonic dissection is associated with lower rates of pancreatic fistula and abdominal abscess [6,7]. In dissection during D2 lymphadenectomy following gastrectomy, Harmonic technology reduced operative time, blood loss and drainage volume [8].…”

A device category economic model of electrosurgery technologies across procedure types: a U.S. hospital budget impact analysis

“…For example, ultrasonic and ABP devices have been associated with reductions in operating room (OR) time as well as length of hospital stay (LOS) [4][5][6][7][8][9] . These devices have also been found to reduce intraoperative bleeding and associated complications [10][11][12] . Reoperations or transfusions are often needed when bleeding events occur perioperatively and as a result, this can increase healthcare resource use, including OR time, LOS, and transfusion costs 13,14 .…”

“…There are numerous devices within these device categories that are tailored to specific specialties, procedures and vessel sizes 2,5,[7][8][9]18,19 . Published meta-analyses have shown the value of ultrasonic energy devices in terms of OR time savings and reductions in blood loss and related complications compared with conventional methods [10][11][12] , with additional clinical studies showing trends toward improvements compared with other advanced energy devices [7][8][9]19,20 . There is also a growing body of literature comparing individual ABP devices from different manufacturers for particular clinical outcomes (e.g.…”