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Haq AU, Bansal C, Pandey AK, Singh VP. Analysis of Different Techniques of Tonsillectomy: An Insight. Indian J Otolaryngol Head Neck Surg 2022; 74:5717-5730. [PMID: 36742922 PMCID: PMC9895602 DOI: 10.1007/s12070-021-02948-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 10/14/2021] [Indexed: 02/07/2023] Open
Abstract
Tonsillectomy is one of the most commonly performed surgical procedure in otolaryngology especially in children. This is an age old procedure which has seen continuous changes in the surgical technique from guillotine method to snare technique to coblation tonsillectomy, and is still evolving day by day. But there are no consensus as to which technique is the best or most appropriate for tonsillectomy. The objective of this study is to compare three different surgical techniques of tonsillectomy namely the Cold dissection snare technique (CDST), Bipolar electro-dissection technique (BEDT) and Harmonic scalpel technique (HST) and to identify the method which is safe, with less operative time, which offers decreased intra-operative blood loss and with lowest post-operative morbidity and complications. This prospective and comparative study was conducted over a time duration of 1 year 6 months from January 2018 to July 2019 after the approval from ethical committee. Total 150 cases of tonsillectomy were done by dividing into three groups of 50 cases each. The study showed maximum cases of tonsillitis in the age group less than 10 years and the most common indication for tonsillectomy being chronic recurrent tonsillitis. Harmonic scalpel technique (HST) had least operative time, least intra-operative blood loss, took minimum time for resumption of normal diet and normal activity and also had least pain score on post-operative day 1st, 5th, 10th and 15th. STATISTICS: Kruskall-Wallis and the non-parametric Analysis of variance (ANOVA) tests were applied to determine statistically significant variances. All the differences are found to be significant P < 0.05. Harmonic Scalpel Technique (HST) is the latest technique as it is associated with quicker procedure, less intraoperative blood loss and less post-operative pain.
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Affiliation(s)
- Ajaz Ul Haq
- Department of ENT, Shri Guru Ram Rai Institute of Medical Sciences, Dehradun, Uttarakhand India
| | - Chetan Bansal
- Department of ENT, ONGC Hospital, Dehradun, Uttarakhand India
| | - Apoorva Kumar Pandey
- Department of ENT, Shri Guru Ram Rai Institute of Medical Sciences, Dehradun, Uttarakhand India
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Spartalis E, Giannakodimos A, Ziogou A, Giannakodimos I, Paschou SA, Spartalis M, Schizas D, Troupis T. Effect of energy-based devices on post-operative parathyroid function and blood calcium levels after total thyroidectomy. Expert Rev Med Devices 2021; 18:291-298. [PMID: 33666537 DOI: 10.1080/17434440.2021.1899805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/07/2022]
Abstract
Introduction: Energy-based devices are widely used in thyroid surgery in order to achieve optimal hemostasis, while their role in the incidence of hypocalcemia and hypoparathyroidism comprises a topic evaluated in numerous studies.Areas covered: The aim of this systematic review is to investigate the potential benefit of Ultrasonic Shears and Electrothermal Bipolar (Radiofrequency) System in thyroid surgery regarding the incidence of post-operative hypocalcemia and hypoparathyroidism. A systematic review of the literature in PubMed/Medline and Scopus databases was conducted. Forty-nine studies met the inclusion criteria and were analyzed. A statistically decreased rate of transient hypocalcemia and hypoparathyroidism was reported in 15 studies and 4 studies, respectively, when using energy-based devices. However, 18 and 13 surveys examined transient hypocalcemia and hypoparathyroidism, respectively, and demonstrated no statistical difference between energy-based devices and conventional hemostasis. No difference was observed between the groups concerning permanent hypocalcemia. Out of 13 studies, only 2 showed a significant reduction in the occurrence of permanent hypoparathyroidism in the energy-based device group.Expert opinion: Energy-based devices reduced the rate of transient hypocalcemia and hypoparathyroidism after thyroid surgeries in 42.8% and 23.5% of the included studies, respectively. Further studies are needed to evaluate their impact on permanent post-operative hypocalcemia and hypoparathyroidism.
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Affiliation(s)
- Eleftherios Spartalis
- 2nd Department of Propaedeutic Surgery, National and Kapodistrian University of Athens, Medical School, Athens, Greece.,Laboratory of Experimental Surgery and Surgical Research "N.S Christeas," National and Kapodistrian University of Athens, Medical School, Athens, Greece.,Department of Anatomy, Medical School, National and Kapodistrian University of Athens, Medical School, Athens, Greece
| | - Alexios Giannakodimos
- 2 Department of Propaedeutic Surgery, National and Kapodistrian University of Athens, Medical School, Athens, Greece
| | - Afroditi Ziogou
- Third Department of Surgery, National and Kapodistrian University of Athens, Attikon University Hospital, Athens, Greece
| | - Ilias Giannakodimos
- 1st Department of Surgery, National and Kapodistrian University of Athens, Athens, Greece
| | - Stavroula A Paschou
- Division of Endocrinology, Diabetes and Metabolism, Department of Clinical Therapeutics, Alexandra Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Michael Spartalis
- Laboratory of Experimental Surgery and Surgical Research "N.S Christeas," National and Kapodistrian University of Athens, Medical School, Athens, Greece
| | - Dimitrios Schizas
- 1st Department of Surgery, National and Kapodistrian University of Athens, Athens, Greece
| | - Theodore Troupis
- Department of Anatomy, Medical School, National and Kapodistrian University of Athens, Medical School, Athens, Greece
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Okhunov Z, Yoon R, Lusch A, Spradling K, Suarez M, Kaler KS, Patel R, Hwang C, Osann K, Huang J, Lee T, Landman J. Evaluation and Comparison of Contemporary Energy-Based Surgical Vessel Sealing Devices. J Endourol 2019; 32:329-337. [PMID: 29463122 PMCID: PMC5909080 DOI: 10.1089/end.2017.0596] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Introduction: We evaluated and compared five currently available energy-based vessel sealing devices to assess typical surgical metrics. Methods: We tested Caiman 5 (C5), Harmonic Scalpel Ace Plus (HA), Harmonic Ace +7 (HA7), LigaSure (LS), and Enseal G2 (ES) on small (2–5 mm), medium (5.1–7 mm), and large (7.1–9 mm) vessels obtained from 15 Yorkshire pigs. Vessels were randomly sealed and transected. We recorded sealing and transection time, charring and carbonization, thermal spread, and bursting pressure (BP). Specimens were sent for histopathologic evaluation of seal quality and thermal spread. Results: A total of 246 vessels were evaluated: 125 were arteries and 121 were veins. There was no difference in BPs for small size arteries. For medium arteries, C5 provided the highest BP (proximal and distal jaw), followed by HA7, ES, LS, and HA [1740, 1600, 1165, 1165, 981, and 571 mm Hg, respectively, HA<C5-D(<0.001); HA<C5-P(<0.001); HA<ES(0.002); HA<HA7(0.002); HA7<C5-P(0.026); ES<C5-P(0.026); LS<C5-P(0.001); LS<C5-D(0.014)]. For large arteries, C5 and LS provided highest BP followed by HA7, ES, and HA [1676, 530, 467, 467, and 254 mm Hg, respectively, C5<HA(<0.001); C5<HA7(0.006); C5<ES(0.006); C5<LS(0.012)]. There were no bursting pressure failures for C5, HA7, and LS up to 9 mm vessels. For medium and large size arteries, HA had bursting failure of 20% and 40%, respectively. The ES was significantly less efficient with small, medium, and large arteries with bursting failure rates of 10%, 40%, and 80%, respectively. Conclusions: In this study, C5 outperformed all other devices. However, all of the devices provide a seal that was superphysiologic in that all burst pressures were >250 mm Hg.
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Affiliation(s)
- Zhamshid Okhunov
- 1 Department of Urology, University of California , Irvine, Orange, California
| | - Renai Yoon
- 1 Department of Urology, University of California , Irvine, Orange, California
| | - Achim Lusch
- 1 Department of Urology, University of California , Irvine, Orange, California
| | - Kyle Spradling
- 2 Department of Urology, University of California , Irvine, Orange, California
| | - Melissa Suarez
- 1 Department of Urology, University of California , Irvine, Orange, California
| | - Kamaljot S Kaler
- 1 Department of Urology, University of California , Irvine, Orange, California
| | - Roshan Patel
- 1 Department of Urology, University of California , Irvine, Orange, California
| | - Christina Hwang
- 1 Department of Urology, University of California , Irvine, Orange, California
| | - Kathy Osann
- 2 Department of Urology, University of California , Irvine, Orange, California
| | - Jiaoti Huang
- 3 Department of Pathology, Duke University , Durham, North Carolina
| | - Thomas Lee
- 4 Department of Pathology, University of California , Irvine, Orange, California
| | - Jaime Landman
- 1 Department of Urology, University of California , Irvine, Orange, California
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Abstract
The implementation of UltraCision (The Harmonic Scalpel) can be seen as a milestone in the development of surgery. Ultrasound is now used for tissue cutting and/or simultaneous vessel sealing and transection. No electric current passes through the patient. Thus the typical complications associated with electrocautery can be avoided. This technology was primarily developed for videoscopic surgery and then successfully transferred to all branches of open surgery. The clean and blood-saving dissection technology and the ability to dissect very close to sensitive structures in oncological surgery are highly beneficial for patients. The development of new blades and multifunctional shears has further enhanced both practicability and ergonomics. UltraCision can now be used for the complete surgical spectrum, both in open and in laparoscopic surgery.
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Affiliation(s)
- W Feil
- a Department of Surgery , Center for Social Medicine East , City of Vienna , Vienna , Austria
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Al-Dhahiry JK, Hameed HM. Total thyroidectomy: Conventional Suture Ligation technique versus sutureless techniques using Harmonic Scalpel or Maxium. Ann Med Surg (Lond) 2016; 5:29-34. [PMID: 26858831 DOI: 10.1016/j.amsu.2015.11.010] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2015] [Revised: 11/22/2015] [Accepted: 11/23/2015] [Indexed: 11/20/2022] Open
Abstract
Objectives Harmonic Scalpel (HS) and Maxium (MAX) are surgical shears that enable simultaneous vessel sealing and tissue coagulation. This study compares the outcome of Total Thyroidectomy (TT) using Conventional Suture Ligation (CSL) technique versus (vs) two sutureless techniques; H S and MAX techniques in terms of safety, operative time, blood drainage volume, hospital stay and surgical complications. Study design This is a prospective observational cohort study. Setting This study was performed in AL-Karama Teaching Hospital/College of Medicine/University of Wasit/Iraq. Patients and methods This study was performed from June 2012 to 2015. A total of 80 patients, 60 patients were females and 20 patients were males (average/mean of age was 39/38 years). They underwent TT after been randomized into the following three groups: CSL group when Suture Ligation Technique was used, HS group when Harmonic Scalpel was used and MAX group when bipolar electrosurgery Maxium was used. Results The postoperative evaluation of operative time, blood drainage volume and surgical complications revealed no statistically significant differences between HS group & MAX group, but there were statistically significant differences between CSL group vs. HS and MAX groups. Operative time statistics showed significant differences between CSL vs. HS and MAX groups, 113 ± 10.9 minutes (min), 93 ± 13 min and 92 ± 10.6 min respectively, p-value < 0.001 and 95% confidence interval [CI] (92.3712, 101.6288). The postoperative blood drainage volumes were significantly different between the three groups: CSL group = 150 ± 12.7 ml, HS group = 89 ± 16.21 ml and MAX group = 118 ± 9.6 ml, P-value = 0.046 and 95% [CI] (89.9932, 99.6068). Conclusions HS and MAX are safe, effective, and time-saving techniques. They are also associated with low blood loss and low complication rates. HS and MAX are good alternative techniques to CSL for thyroid surgery. HS and MAX are safe useful and fast alternatives to conventional techniques in total thyroidectomy. These two devices facilitate surgical procedures and cancel any need for clips and suture ligations. They significantly reduce operative time without increases in the amount of blood losses and hospital stay. Probably the only disadvantage of these two devices is the cost of the single-use devices.
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Revelli L, Damiani G, Bianchi CBNA, Vanella S, Ricciardi W, Raffaelli M, Lombardi CP. Complications in thyroid surgery. Harmonic Scalpel, Harmonic Focus versus Conventional Hemostasis: A meta-analysis. Int J Surg 2016; 28 Suppl 1:S22-32. [PMID: 26768409 DOI: 10.1016/j.ijsu.2015.12.050] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2015] [Revised: 04/29/2015] [Accepted: 05/20/2015] [Indexed: 11/19/2022]
Abstract
BACKGROUND To evaluate the incidence of postoperative complications, hemostatic effects and safety of Total Thyroidectomy (TT) performed using the Harmonic Scalpel (HS), the Harmonic Focus (HF) or Conventional Hemostasis (CH). METHODS The meta-analysis was performed according to PRISMA guidelines. A literature search was conducted from 2003 to 2014 and stringent criteria were required for inclusion. Thirteen studies concerning an overall population of 1458 compared HS versus CH, whilst 8 studies with 1667 patients compared HF versus CH. RESULTS There was a significant reduction of operative time (Mean Difference [MD] = -25.49 min.; 95% CI -32.43 to -18.55), intraoperative blood loss (MD = -30.49 mL; 95% CI -53.01 to -7.97), postoperative drainage volume (MD = -12.90 mL; 95% CI -22.83 to -2.98) and postoperative pain (MD = -0.87; 95% CI -1.27 to -0.46) in patients underwent TT with HS. Regarding HF group, a significant reduction of operative time (MD = -25.99 min., 95% CI -34.56 to -17.41), length of hospital stay (MD = -0.57; 95% CI -0.97 to -0.17), transient hypocalcemia (OR = 0.56; 95% CI 0.39 to 0.81) and postoperative pain (MD = -1.33 days; 95% CI -2.49 to -0.17) resulted. CONCLUSIONS HS TT can be a safe, useful and fast alternative to conventional TT. The newer HF can reduce the rate of hypocalcemia. Future RCTs of larger patient cohorts with more detailed data of postoperative complications, cost-effectiveness and cosmetic results, randomization procedures, intention-to-treat analyses and blinding of outcome assessors are needed to draw more meaningful conclusions.
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Affiliation(s)
- Luca Revelli
- Department of Surgical Sciences, University Hospital Agostino Gemelli, Catholic University of Sacred Heart, Rome, Italy.
| | - Gianfranco Damiani
- Department of Public Health, University Hospital Agostino Gemelli, Catholic University of Sacred Heart, Rome, Italy.
| | | | - Serafino Vanella
- Department of Surgical Sciences, University Hospital Agostino Gemelli, Catholic University of Sacred Heart, Rome, Italy.
| | - Walter Ricciardi
- Department of Public Health, University Hospital Agostino Gemelli, Catholic University of Sacred Heart, Rome, Italy.
| | - Marco Raffaelli
- Department of Surgical Sciences, University Hospital Agostino Gemelli, Catholic University of Sacred Heart, Rome, Italy.
| | - Celestino Pio Lombardi
- Department of Surgical Sciences, University Hospital Agostino Gemelli, Catholic University of Sacred Heart, Rome, Italy.
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Gizzo S, Andrisani A, Ancona E, Quaranta M, Vitagliano A, Noventa M, Nardelli GB, Ambrosini G. Could Harmonic Scalpel (Ultracision®) be considered the best device in surgical treatment of vulvar cancer of patients with implanted pace-maker? Proposal and rationale. Int J Clin Exp Med 2015; 8:9805-9809. [PMID: 26309660 PMCID: PMC4538085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2015] [Accepted: 06/03/2015] [Indexed: 06/04/2023]
Abstract
Vulvar cancer (VC) represents about 4% of gynecologic malignancies, its incidence increases with age and peak incidence is found between 70-79 years. In cases of locally advanced disease surgery is often required and radical vulvectomy, with or without mono-bilateral inguino-femoral lymphadenectomy, is standard management. Various devices have been implemented in gynecological surgery in an attempt to minimize or avoid frequent intra/postoperative complications linked to energy use, unfortunately the majority of these devices require monopolar or bipolar energy. Ultracision® represents a unique surgical device capable of performing both cutting and coagulation at different intensities without use of electric energy. The use of Ultracision® in the radical treatment of VC has advantages both in terms of intraoperative and postoperative complications responsible for the reduction of surgical time and blood loss, complete tissue removal according to oncological criteria, diminished desensitization of peripheral areas and reduction of wound complications. These advantages have been widely demonstrated and contribute to making Ultracision® a cost-effective option in the routine treatment of patients affected by vulvar cancer especially when considering its safety in cardiopathic patients with implanted pacemaker. If the impressive results achieved in radical vulvar surgery will be confirmed, scalpel use could be proposed as routine for surgery of the routinely in surgical approach of vulvar and perineal area, in both benign and malignant disease.
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Affiliation(s)
- Salvatore Gizzo
- Department of Woman and Child Health, University of PaduaPadua, Italy
| | | | - Emanuele Ancona
- Department of Woman and Child Health, University of PaduaPadua, Italy
| | - Michela Quaranta
- Department of Obstetrics and Gynecology, University of VeronaVerona, Italy
| | | | - Marco Noventa
- Department of Woman and Child Health, University of PaduaPadua, Italy
| | | | - Guido Ambrosini
- Department of Woman and Child Health, University of PaduaPadua, Italy
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Abstract
OBJECTIVE The Harmonic Scalpel (HS) has been recently widely used to perform a variety of surgical procedures. We reviewed our experience with the use of HS in superficial parotidectomy to determine the safety and efficacy of this procedure, with regard to operative time, postoperative facial nerve function, and drainage output. STUDY DESIGN Nonrandomized retrospective review. MATERIALS AND METHODS The medical records of all patients who underwent superficial parotidectomy for benign pathology at Shaare Zedek Medical Center from January 2006 to July 2009 were retrospectively reviewed. Patients with prior facial nerve weakness or prior parotid surgery or who had undergone concurrent neck dissection or total parotidectomy were excluded. RESULTS Fifty-eight patients were reviewed; 26 patients underwent HS parotidectomy and 32 patients underwent conventional (cold knife) parotidectomy (control group). Harmonic Scalpel assisted parotidectomy was associated with significantly decreased length of surgery from 163.12 ± 21.8 minutes for controls to 137.3 ± 18.6 minutes in the HS assisted group (P < .05). The incidence of temporary postoperative facial nerve paresis was significantly reduced from 43% in the controls to 23% in the HS group (P < .05). No permanent facial nerve paralysis was reported. There were differences in the overall postoperative drain output between the HS and control groups, 68 ± 22.3 mL and 73.5 ± 38.2 mL, respectively, but these differences did not achieve significance. CONCLUSION This study shows that HS assisted superficial parotidectomy for benign pathology is a safe technique and associated with reduced surgical time and incidence of temporary postoperative facial nerve paresis compared with conventional techniques.
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Affiliation(s)
- Nidal Muhanna
- Department of Otolaryngology-Head & Neck Surgery, Shaare Zedek Medical Center, Jerusalem, Israel
| | - Uri Peleg
- Department of Otolaryngology-Head & Neck Surgery, Shaare Zedek Medical Center, Jerusalem, Israel
| | - Yehuda Schwartz
- Department of Otolaryngology-Head & Neck Surgery, Shaare Zedek Medical Center, Jerusalem, Israel
| | - Hanan Shaul
- Department of Otolaryngology-Head & Neck Surgery, Shaare Zedek Medical Center, Jerusalem, Israel
| | - Ronen Perez
- Department of Otolaryngology-Head & Neck Surgery, Shaare Zedek Medical Center, Jerusalem, Israel
| | - Jean-Yves Sichel
- Department of Otolaryngology-Head & Neck Surgery, Shaare Zedek Medical Center, Jerusalem, Israel
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Peker K, İnal A, Güllü H, Gül D, Şahin M, Ozcan AD, Kılıç K. Comparison of vessel sealing systems with conventional. Iran Red Crescent Med J 2013; 15:488-96. [PMID: 24349747 PMCID: PMC3840836 DOI: 10.5812/ircmj.10180] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/08/2013] [Revised: 05/03/2013] [Accepted: 05/11/2013] [Indexed: 01/22/2023]
Abstract
Background Haemorrhoids 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. Objectives The aim of this study was to compare the effectiveness of the LigaSure tissue sealing device, Harmonic Scalpel and conventional MM open haemorrhoidectomy. Materials and Methods Sixty-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. Results Each 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. Conclusions Lateral 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.
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Affiliation(s)
- Kemal Peker
- Erzincan University Department of General Surgery, Erzincan, Turkey
- Corresponding author: Kemal Peker, Mengücek Gazi Eğitim ve Araştırma Hastanesi Genel Cerrahi, Turkey. Tel: +90-5359368528, Fax: +90-4462122216, E-mail:
| | - Abdullah İnal
- Erzincan University Department of General Surgery, Erzincan, Turkey
| | - Huriye Güllü
- Erzincan University Department of Anesthesiology & Reanimation, Erzincan, Turkey
| | - Düriye Gül
- Erzincan University Department of Anesthesiology & Reanimation, Erzincan, Turkey
| | - Murat Şahin
- Erzincan University Department of Anesthesiology & Reanimation, Erzincan, Turkey
| | - Ayca Dumanli Ozcan
- Palandoken State Hospital Department of Anesthesiology & Reanimation, Erzurum, Turkey
| | - Kemal Kılıç
- Kafkas University Department of General Surgery, Kars, Turkey
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Hotta T, Takifuji K, Yokoyama S, Matsuda K, Higashiguchi T, Tominaga T, Oku Y, Watanabe T, Nasu T, Hashimoto T, Tamura K, Ieda J, Yamamoto N, Iwamoto H, Yamaue H. Literature review of the energy sources for performing laparoscopic colorectal surgery. World J Gastrointest Surg 2012; 4:1-8. [PMID: 22347536 PMCID: PMC3277876 DOI: 10.4240/wjgs.v4.i1.1] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2010] [Revised: 10/26/2011] [Accepted: 12/08/2011] [Indexed: 02/06/2023] Open
Abstract
Laparoscopic surgery for colorectal disease has become widespread as a minimally invasive treatment. This is important because the increasing availability of new devices allows us to perform procedures with a reduced length of surgery and decreased blood loss. We herein report the results of a literature review of energy sources for laparoscopic colorectal surgery, focused especially on 6 studies comparing ultrasonic coagulating shears (UCS) and other instruments. We also describe our laparoscopic dissection techniques using UCS for colorectal cancer. The short-term outcomes of surgeries using UCS and Ligasure for laparoscopic colorectal surgery were superior to conventional electrosurgery. Some authors have reported that the length of surgery or blood loss when Ligasure was used for laparoscopic colorectal surgery is less than when UCS was used. On the other hand, a recent study demonstrated that there were no significant differences between the short-term outcomes of UCS and Ligasure for laparoscopic colorectal surgery. It is therefore suggested that the choice of technique used should be made according to the surgeon’s preference. We also describe our laparoscopic dissection techniques using UCS (Harmonic ACE) for colorectal cancer with regard to the retroperitoneum dissection, dissection technique, dissection technique around the feeding artery, and various other dissection techniques. We therefore review the outcomes of using various energy sources for laparoscopic colorectal surgery and describe our laparoscopic dissection techniques with UCS (Harmonic ACE) for colorectal cancer.
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Affiliation(s)
- Tsukasa Hotta
- Tsukasa Hotta, Katsunari Takifuji, Shozo Yokoyama, Kenji Matsuda, Takashi Higashiguchi, Toshiji Tominaga, Yoshimasa Oku, Takashi Watanabe, Toru Nasu, Tadamichi Hashimoto, Koichi Tamura, Junji Ieda, Naoyuki Yamamoto, Hiromitsu Iwamoto, Hiroki Yamaue, Second Department of Surgery, Wakayama Medical University, School of Medicine, Wakayama 641-8510, Japan
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