Comparison of LigaSure Vessel Sealing System, Harmonic Scalpel, and Cold Knife Tonsillectomy

Lachanas, Vassilios A.; Hajiioannou, Jiannis; Karatzias, George T.; Filios, Dimitrios; Koutsias, Stylianos; Mourgelas, Charalambos

doi:10.1016/j.otohns.2007.05.012

Cited by 41 publications

(46 citation statements)

References 19 publications

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“…However, no significant difference of pain on postoperative day 2 to day 14 (p = 0.055-0.983) between both groups. These results were different from the previous studies for VSST [7,8,18]. Lachanas et al reported the overall mean pain score for the VSST group was significantly lower than the CKT group (p \ 0.01).…”

Section: Discussioncontrasting

confidence: 75%

“…Several different techniques are used to perform this operation, including cold knife, monopolar cautery, coblation, and radiofrequency [1][2][3][4][5][6][7][8][9][10]. Efficacy in hemostasis and tissue trauma from different operative techniques may result in different operative time and different degrees of morbidity including intraoperative blood loss, postoperative pain, postoperative hemorrhage, and velopharyngeal insufficiency (VPI).…”

Section: Introductionmentioning

confidence: 99%

“…It was also found quite effective and safe in tonsillectomy procedures, providing excellent hemostasis and minimal tissue trauma. [1,[6][7][8]. The VSS is a bipolar vascular sealing system, with integrated active feedback control.…”

Section: Introductionmentioning

confidence: 99%

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Vessel sealing system uvulopalatoplasty versus uvulopalatal flap: a randomized, controlled study of efficacy and adverse effects

Hirunwiwatkul

Kanjanaumporn

2011

Eur Arch Otorhinolaryngol

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The objective of this randomized, controlled study is to compare intraoperative blood loss, operative time, postoperative pain and postoperative adverse effects (bleeding, velopharyngeal insufficiency and others) between vessel sealing system uvulopalatoplasty (VSSU) and uvulopalatal flap (UPF). The study was conducted at the Department of Otolaryngology, King Chulalongkorn Memorial Hospital, Bangkok, Thailand. 31 subjects with sleep-disordered breathing and obstruction at the retropalatal level were enrolled consecutively. Intervention was randomized by mixed block randomization into 2 groups (UPF, VSSU). Stratification was also done by the presence or absence of concomitant tonsillectomy. Measured outcomes, which were blinded to patients and outcome assessor, were intraoperative blood loss, operative time, postoperative pain, postoperative bleeding, postoperative velopharyngeal insufficiency and other adverse effects. Median (IQR) of intraoperative blood loss from VSSU and UPF was 0.00 (0.00-1.00) and 6.00 (1.25-12.75) ml (p < 0.001). Median (IQR) of operative time from VSSU and UPF was 3.50 (3.00-5.00) and 15.00 (12.25-18.00) min (p < 0.001). There was significantly less pain in VSSU group on operative day (p = 0.001) and postoperative day 1 (p = 0.009). However, no significant difference of pain on postoperative day 2 to day 14 (p = 0.055-0.983) between both groups. Regarding postoperative bleeding, 1 case of immediate bleeding in UPF group and 1 case of delayed bleeding in VSSU group were found in this study. Postoperative velopharyngeal insufficiency and other adverse effects were not found in both groups. In conclusion, VSSU was better than UPF in terms of less intraoperative blood loss, less operative time and less pain in early postoperative period. Postoperative velopharyngeal insufficiency and other adverse effects were not found in both groups.

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Section: Discussioncontrasting

confidence: 75%

Section: Introductionmentioning

confidence: 99%

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Vessel sealing system uvulopalatoplasty versus uvulopalatal flap: a randomized, controlled study of efficacy and adverse effects

Hirunwiwatkul

Kanjanaumporn

2011

Eur Arch Otorhinolaryngol

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“…19,20 It was female patients who commonly got affected in our study in the ratio of 1:3 and 1:2.63 in both the groups respectively. In group A the median age of male and female patients was 48.7yrs and 43.5yrs respectively.in group B it was 47.9% and 44.8% respectively.…”

Section: Resultsmentioning

confidence: 50%

Control of cystic artery during laparoscopic cholecystectomy: clips versus ultrasonic energy devices which is better?

Venkatapuram

Sateesh

2017

Int Surg J

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Background: This study was undertaken to know whether clip usage or ultrasonic energy application, obtains better haemostasis of cystic artery during laparoscopic cholecystectomy.Methods: About 80 patients undergoing laparoscopic cholecystectomy were selected on a prospective basis and divided into two equal groups- A and B. a comparative study was done between the two group. Clips were used to control cystic artery in group A patients and ultrasonic energy device was used for the same in group B.Results: In group A, 2 patients had clip slippage intraoperatively which was dealt by reapplication of clips.in group B,1 patient had intraoperative bleeding from cystic artery few minutes after application of ultrasonic energy which was dealt by bipolar cauterization. In both the groups no, postoperative bleeding was encountered.Conclusions: During laparoscopic cholecystectomy, clip usage and ultrasonic energy application are equally competent in achieving haemostasis of cystic artery.

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“…It covers almost 20% of otolaryngology operations in our practice [1]. The first tonsil removal was performed by Celsus in 30 b.c [2] and many techniques such as blunt dissection, electrocautery, cryosurgery, ultrasonic removal, laser tonsillectomy, thermal welding, monopolar and bipolar diathermy (BD) have been used since then with the aim of improving safety and reducing complications [3][4][5]. However, the optimum technique and instrumentation for tonsillectomy are still controversial [6].…”

Section: Introductionmentioning

confidence: 99%

Harmonic scalpel versus bipolar tonsillectomy: a double-blind clinical trial

Özgür

2011

Eur Arch Otorhinolaryngol

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This is a double bind clinical trial which evaluated harmonic scalpel versus bipolar diathermy tonsillectomy The study was conducted at Diyarbakir government hospital, Diyarbakir, Turkey. The study population comprised 144 patients, aged 4-18 years (mean 9 years ± 4.12 SD). All patients underwent tonsillectomy with or without adenoidectomy. The indications for tonsillectomy were obstructive sleep apnea (84 patients [58.3%]) and chronic tonsillitis (60 patients [41.7%]). All 144 patients were randomly divided into two groups: bipolar dissection (81 patients [56.2%] with mean age 8.98 years ± 4.22) and harmonic scalpel (63 patients [43.8%] with mean age 9 years ± 4.02). BD group showed statistically significantly less intraoperative bleeding (< 0.05). There was no statistically significant difference on postoperative day 1 but a statistically significant difference was determined on postoperative days 4, 7 and 14. There was no statistically significant difference between the two techniques with regard to immediate and delayed bleeding. The mean operative time was the same in both the groups. Bipolar dissection group showed statistically significant less intraoperative bleeding than harmonic scalpel group. An analysis of postoperative pain scores showed that the harmonic scalpel group pain scores are lower than the bipolar dissection group on all recorded days, and no statistically significant complications was seen in both groups. The results of this study indicate that the HS technique is associated with lower pain scores with the same complication rates as the BD technique.

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Comparison of LigaSure Vessel Sealing System, Harmonic Scalpel, and Cold Knife Tonsillectomy

Abstract: LT and HST have shown comparable results regarding intraoperative blood loss, postoperative hemorrhage, and pain. Compared with CKT, both were associated with less intraoperative blood loss and pain.

Cited by 41 publications

References 19 publications

Vessel sealing system uvulopalatoplasty versus uvulopalatal flap: a randomized, controlled study of efficacy and adverse effects

Vessel sealing system uvulopalatoplasty versus uvulopalatal flap: a randomized, controlled study of efficacy and adverse effects

Control of cystic artery during laparoscopic cholecystectomy: clips versus ultrasonic energy devices which is better?

Harmonic scalpel versus bipolar tonsillectomy: a double-blind clinical trial

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