Usefulness of the LigaSure Vessel Sealing System During Superficial Lobectomy of the Parotid Gland

Abstract

To evaluate the usefulness of the LigaSure Precise instrument in superficial lobectomy of the parotid gland. Design: Prospective study of the surgical procedures in the LigaSure Vessel Sealing System and comparison with a conventionally treated control group. Setting: Secondary care academic referral center. Patients: Thirty-five patients with a parotid gland benign tumor were randomly allocated to 2 superficial lobe parotidectomy groups: 17 using the LigaSure procedure (group A) and 18 using the conventional method (group B). Main Outcome Measures: During the past few years, different methods of achieving hemostasis in parotid gland surgery have been tested as means of decreasing operative time and facial nerve injuries by controlling bleeding. With the whole LigaSure Vessel Sealing System, we experienced the usefulness of the LigaSure Precise instrument in superficial lobectomy of the parotid gland. Results: No statistically significant differences were noted between the 2 groups in mean age, tumor diameter, length of hospital stay, time to return to work, or number of adverse events during or after surgery. Operative time was significantly shorter in group A than in group B (PϽ.001). Total operative time for conservative partial parotidectomy with traditional excision ranged from 115 to 235 minutes (mean, 155.8 minutes). Using the LigaSure system, the mean operative time was 136.4 minutes. Salivary fistulas were more common in group A (3 of 17 patients), with no cases in group B. Conclusions: The LigaSure method is comparable with but not superior to the conventional method. The main advantages of the LigaSure system are its "sutureless technique" and operative time savings; however, the cost is considerably higher.

Vessel Sealing Device in Parotid Gland Surgery: Clinical and Pathological Study

“…It was considered that because bigger and deeper lobes of parotid gland tumour were included in the LigaSure TM Small Jaw group, therefore excessive blood loss was experienced in these cases compared with the traditional method cases. On the other hand, less bleeding has been reported when using LigaSurePrecise TM than the traditional methods, especially in patient who are at risk of haemorrhage (Prokopakis et al, 2005;Colella et al, 2005). The United States FDA (US Food and Drug Administration) authorizes LigaSure TM for cutting blood vessels and lymphatic vessels up to 7mm in diameter, and the resisting pressure is reported to be three times or more than usual arterial pressure (Kennedy et al, 1998;Heniford et al, 2001;Harold et al, 2003;Dubuc-Lissoir, 2003).Therefore, it was suggested that less bleeding was accomplished.…”

“…Preservation of the facial nerve was thought to be possible, if there was a distance of 1mm or more between the cutting edge and the facial nerve. It was reported that facial palsy was also a rare complication after parotid gland surgery using LigaSurePrecise TM (Prokopakis et al, 2005;Colella et al, 2005).…”

“…Thus, it is reported to save operation time by reducing sutures in thyroid surgery (Schiphorst et al, 2012). Although the conventional dissection technique using the hand-tie ligation technique and a bipolar electrode knife has been usual practice, some reports have described use of LigaSure Precise TM , an earlier model of LigaSure TM Small Jaw, in parotid gland surgery (Prokopakis et al, 2005;Colella et al, 2005;Colella and Giudice, 2006) Shortening of the operative time and decrease in risk of facial nerve damage were reported for using LigaSurePrecise TM (Prokopakis et al, 2005;Colella et al, 2005).The difference between LigaSurePrecise TM and LigaSure TM Small Jaw, which debuted in 2007, is the addition of a cutter. The basic mechanism is considered to be the same, although it is said that performance, such as sealing time, is improved in the new model.…”

Effectiveness of Ankaferd Blood Stopper on salivary gland bleeding

“…Bazı cerrahlar sinir diseksiyonu ve kanama kontrolü için klemp kullanmayı, bazıları ise diseksiyonu hızlandırmak için hemostaz amacıyla ultrasonik bı-çak, monopolar ve bipolar koagülasyon da dahil çeşit-li yöntemler kullanmayı tercih ederler. [11] Parotis cerrahisinde kanayan damarları koagüle ederek dokuları ayıran monopolar elektrokoterin kullanımı fasyal sinirde termal veya elektriksel yaralanma yaparak ameliyat sonrası dönemde sinir fonksiyonlarında zayıflığa yol açabilir. [12] Kanamayı çabuk ve etkili bir şekilde durdurmak cerrahinin başarısını arttırır.…”

Harmonic focus in thyroidectomy for substernal goiter

“…A harmonic scalpel uses ultrasound technology to denature proteins in vessel walls and tissues. Harmonic scalpel is able to seal vessels up to 5 mm in diameter, whereas bipolar electrosurgical devices only seal vessels reliably up to 2 mm in diameter [10,11]. It can be used for ligation, dissection and cutting.…”