BACKGROUND: Over recent years, use of the LigaSure™ vessel sealing device has increased in major abdominal surgery to include pancreaticoduodenectomy (PD). LigaSure™ use during PD has expanded to include all steps of the procedure, including the division of the uncinate margin. This introduces the potential for thermal major vascular injury or margin positivity. The aim of the present study was to evaluate the safety and efficacy of LigaSure™ usage in PD in comparison to established dissection techniques. METHODS: One hundred and forty-eight patients who underwent PD from 2007 to 2012 at Robert Wood Johnson University Hospital were identified from a retrospective database. Two groups were recognized: those in which the LigaSure™ device was used (N = 114), and in those it was not (N = 34). Peri-operative outcomes were compared. RESULTS: Vascular intra-operative complications directly caused by thermal injury from LigaSure™ use occurred in 1.8% of patients. Overall vascular intra-operative complications, uncinate margin positivity, blood loss, length of stay, and complication severity were not significantly different between groups. The mean operative time was 77 min less (P < 0.010) in the LigaSure™ group. Savings per case where the LigaSure™ was used amounted to $1776.73. CONCLUSION: LigaSure™ usage during PD is safe and effective. It is associated with decreased operative times, which may decrease operative costs in PD.
BACKGROUND: Over recent years, use of the LigaSure™ vessel sealing device has increased in major abdominal surgery to include pancreaticoduodenectomy (PD). LigaSure™ use during PD has expanded to include all steps of the procedure, including the division of the uncinate margin. This introduces the potential for thermal major vascular injury or margin positivity. The aim of the present study was to evaluate the safety and efficacy of LigaSure™ usage in PD in comparison to established dissection techniques. METHODS: One hundred and forty-eight patients who underwent PD from 2007 to 2012 at Robert Wood Johnson University Hospital were identified from a retrospective database. Two groups were recognized: those in which the LigaSure™ device was used (N = 114), and in those it was not (N = 34). Peri-operative outcomes were compared. RESULTS: Vascular intra-operative complications directly caused by thermal injury from LigaSure™ use occurred in 1.8% of patients. Overall vascular intra-operative complications, uncinate margin positivity, blood loss, length of stay, and complication severity were not significantly different between groups. The mean operative time was 77 min less (P < 0.010) in the LigaSure™ group. Savings per case where the LigaSure™ was used amounted to $1776.73. CONCLUSION: LigaSure™ usage during PD is safe and effective. It is associated with decreased operative times, which may decrease operative costs in PD.
Authors: Matthew H G Katz; Nipun B Merchant; Steven Brower; Megan Branda; Mitchell C Posner; L William Traverso; Ross A Abrams; Vincent J Picozzi; Peter W T Pisters Journal: Ann Surg Oncol Date: 2010-09-01 Impact factor: 5.344
Authors: Tobias Gehrig; Beat P Müller-Stich; Hannes Kenngott; Lars Fischer; Arianeb Mehrabi; Markus W Büchler; Carsten N Gutt Journal: Am J Surg Date: 2011-02 Impact factor: 2.565
Authors: C Max Schmidt; Emilie S Powell; Constantin T Yiannoutsos; Thomas J Howard; Eric A Wiebke; Chad A Wiesenauer; Joel A Baumgardner; Oscar W Cummings; Lewis E Jacobson; Thomas A Broadie; David F Canal; Robert J Goulet; Eardie A Curie; Higinia Cardenes; John M Watkins; Patrick J Loehrer; Keith D Lillemoe; James A Madura Journal: Arch Surg Date: 2004-07