Use of an electrothermal bipolar sealing device in ligation of major mesenteric vessels during laparoscopic colorectal resection.

Hdl Handle:
http://hdl.handle.net/10147/207621
Title:
Use of an electrothermal bipolar sealing device in ligation of major mesenteric vessels during laparoscopic colorectal resection.
Authors:
Martin, S T; Heeney, A; Pierce, C; O'Connell, P R; Hyland, J M; Winter, Desmond C
Affiliation:
Department of Colorectal Surgery, St. Vincent's University Hospital, Elm Park,, Dublin 4, Ireland.
Citation:
Tech Coloproctol. 2011 Sep;15(3):285-9. Epub 2011 Jul 15.
Journal:
Techniques in coloproctology
Issue Date:
1-Feb-2012
URI:
http://hdl.handle.net/10147/207621
DOI:
10.1007/s10151-011-0707-3
PubMed ID:
21761166
Abstract:
BACKGROUND: A variety of approaches are available for division of major vascular structures during laparoscopic colorectal resection. Ultrasonic coagulating shears (UCS), vascular staplers, plastic or titanium clips and electrothermal bipolar vessel sealing (EBVS) are currently available. We report our experience with an EBVS device, LigaSure (Covidien AG), used in division of the ileocolic, middle colic and inferior mesenteric arteries during laparoscopic colorectal resection. METHODS: We report the immediate outcome of 802 consecutive unselected patients who underwent elective laparoscopic colorectal cancer resection performed with use of the LigaSure (5 and 10 mm) at our institution over a 5-year period. Operative procedures included right hemicolectomy (n = 180), left hemicolectomy (n = 96), sigmoid colectomy (n = 347) and anterior resection (n = 179). Data were collected from a prospectively maintained cancer database and operative records. The procedures were performed primarily by three consultant surgeons with an interest in laparoscopic colorectal resection. RESULTS: Of 802 cases in which the LigaSure device was employed to divide major vascular structures, immediate effective vessel sealing was achieved in 99.8% (n = 800). Two patients experienced related adverse events both following division of the inferior mesenteric artery with a 5 mm LigaSure. Both patients had immediate uncontrolled haemorrhage that required laparotomy. CONCLUSIONS: Use of the LigaSure device to seal and divide the major mesenteric vessels during laparoscopic colorectal resection is very effective, with a high success rate of 99.8%. Caution should be exercised in elderly atherosclerotic patients, particularly when using the 5-mm LigaSure device.
Language:
eng
MeSH:
Aged; Aged, 80 and over; Blood Loss, Surgical/*prevention & control; Colectomy; Colorectal Neoplasms/*surgery; Electrocoagulation/adverse effects/*instrumentation; Female; Hemostasis, Surgical/*methods; Humans; Laparoscopy; Ligation/adverse effects/instrumentation; Male; Mesenteric Artery, Inferior/*surgery; Middle Aged
ISSN:
1128-045X (Electronic); 1123-6337 (Linking)

Full metadata record

DC FieldValue Language
dc.contributor.authorMartin, S Ten_GB
dc.contributor.authorHeeney, Aen_GB
dc.contributor.authorPierce, Cen_GB
dc.contributor.authorO'Connell, P Ren_GB
dc.contributor.authorHyland, J Men_GB
dc.contributor.authorWinter, Desmond Cen_GB
dc.date.accessioned2012-02-01T10:33:07Z-
dc.date.available2012-02-01T10:33:07Z-
dc.date.issued2012-02-01T10:33:07Z-
dc.identifier.citationTech Coloproctol. 2011 Sep;15(3):285-9. Epub 2011 Jul 15.en_GB
dc.identifier.issn1128-045X (Electronic)en_GB
dc.identifier.issn1123-6337 (Linking)en_GB
dc.identifier.pmid21761166en_GB
dc.identifier.doi10.1007/s10151-011-0707-3en_GB
dc.identifier.urihttp://hdl.handle.net/10147/207621-
dc.description.abstractBACKGROUND: A variety of approaches are available for division of major vascular structures during laparoscopic colorectal resection. Ultrasonic coagulating shears (UCS), vascular staplers, plastic or titanium clips and electrothermal bipolar vessel sealing (EBVS) are currently available. We report our experience with an EBVS device, LigaSure (Covidien AG), used in division of the ileocolic, middle colic and inferior mesenteric arteries during laparoscopic colorectal resection. METHODS: We report the immediate outcome of 802 consecutive unselected patients who underwent elective laparoscopic colorectal cancer resection performed with use of the LigaSure (5 and 10 mm) at our institution over a 5-year period. Operative procedures included right hemicolectomy (n = 180), left hemicolectomy (n = 96), sigmoid colectomy (n = 347) and anterior resection (n = 179). Data were collected from a prospectively maintained cancer database and operative records. The procedures were performed primarily by three consultant surgeons with an interest in laparoscopic colorectal resection. RESULTS: Of 802 cases in which the LigaSure device was employed to divide major vascular structures, immediate effective vessel sealing was achieved in 99.8% (n = 800). Two patients experienced related adverse events both following division of the inferior mesenteric artery with a 5 mm LigaSure. Both patients had immediate uncontrolled haemorrhage that required laparotomy. CONCLUSIONS: Use of the LigaSure device to seal and divide the major mesenteric vessels during laparoscopic colorectal resection is very effective, with a high success rate of 99.8%. Caution should be exercised in elderly atherosclerotic patients, particularly when using the 5-mm LigaSure device.en_GB
dc.language.isoengen_GB
dc.subject.meshAgeden_GB
dc.subject.meshAged, 80 and overen_GB
dc.subject.meshBlood Loss, Surgical/*prevention & controlen_GB
dc.subject.meshColectomyen_GB
dc.subject.meshColorectal Neoplasms/*surgeryen_GB
dc.subject.meshElectrocoagulation/adverse effects/*instrumentationen_GB
dc.subject.meshFemaleen_GB
dc.subject.meshHemostasis, Surgical/*methodsen_GB
dc.subject.meshHumansen_GB
dc.subject.meshLaparoscopyen_GB
dc.subject.meshLigation/adverse effects/instrumentationen_GB
dc.subject.meshMaleen_GB
dc.subject.meshMesenteric Artery, Inferior/*surgeryen_GB
dc.subject.meshMiddle Ageden_GB
dc.titleUse of an electrothermal bipolar sealing device in ligation of major mesenteric vessels during laparoscopic colorectal resection.en_GB
dc.contributor.departmentDepartment of Colorectal Surgery, St. Vincent's University Hospital, Elm Park,, Dublin 4, Ireland.en_GB
dc.identifier.journalTechniques in coloproctologyen_GB
dc.description.provinceLeinster-

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