Radiofrequency versus ultrasonic energy in laparoscopic colorectal surgery: a metaanalysis of operative time and blood loss

Abstract

Background Various energy sources are available for tissue dissection and vessel sealing in laparoscopic colorectal surgery. The electrothermal bipolar vessel sealing system (EBVS) and ultrasonic energy (UE) devices are widely used to provide hemostatic dissection in laparoscopic procedures. Nevertheless, available evidencedbased data comparing their operative results still are scarce. This study conducted a metaanalysis of controlled clinical trials comparing EBVS and UE in terms of operative time and intraoperative blood losses in laparoscopic colorectal surgery Methods The MEDLINE and Embase databases were searched using medical subject headings and free text words. All randomized controlled trials (RCTs) and controlled clinical trials using EBVS and UE in laparoscopic colorectal surgery were considered for inclusion in the study. Random effects models were used in case of heterogeneity to obtain summary statistics for the overall difference in operating time and blood loss between instruments.Results Four studies comparing EBVS with UE for 397 patients (200 EBVS vs. 197 UE patients) were included in the study. The findings showed that EBVS was associated with a significantly shorter operative time and less intraoperative blood loss than UE (p \ 0.05). Conclusions The metaanalysis indicated that EBVS is associated with a shorter operative time and less blood loss than UE in laparoscopic colorectal surgery. However, these results should be interpreted with caution due to the high heterogeneity of the included trials and the limited number of studies with a high level of evidence. More adequately designed RCTs with a larger number of patients are required to confirm the results of this metaanalysis.

Influence of multiple reuse and resterilization cycles on the performance of a bipolar vessel sealing device (LigaSure) intended for single use

“…Electrothermal bipolar vessel sealing devices (EBVS) were initially developed to facilitate rapid hemostasis during minimally invasive procedures 1 but have since been demonstrated to achieve excellent hemostasis in multiple open operative situations. [2][3][4] One such EBVS is the LigaSure (Covidien Medtronic, Minneapolis, Minnesota). This instrument is in widespread use in veterinary surgery.…”

A New In Vitro Model to Study Cellular Responses after Thermomechanical Damage in Monolayer Cultures

“…The diagramme shows that there was a highly significant increase in THP-1 adhesion in the areas affected by thermal damage compared to the stamp control. Furthermore, we observed a highly significant increase in the number of adherent THP-1 in the affected areas (2,4,6,9) compared to the unaffected areas (1,3,7,8) of the same well, but only in the case of the thermally damaged HUVEC. Interestingly, we observed a significant increase of adhered THP-1 after thermal damage in the centre area (5) as well.…”

“…Since the middle of the last century, electrosurgery has become routine in open and minimal invasive surgeries: it is used to achieve division of tissue [1], and has most recently been employed for more advanced applications such as blood vessel sealing and hemostasis [2–5]. Besides mechanical interventions such as suturing or stapling, sealing by using bipolar current offers an alternative for blood vessel closure in surgeries, resulting in a low total operative time and reduced blood loss [6,7].…”

Performance of Harmonic devices in surgical oncology: an umbrella review of the evidence

“…The quality of included SRs in this category varied considerably with two lower quality SRs [ 28 , 29 ] and one higher quality Cochrane Review [ 30 ] according to AMSTAR (Table 2 ). Included trials in these SRs were comprised of a mixed population of patients with benign and malignant colon diseases (including diverticulitis, polyps, colorectal adenoma and adenocarcinoma, and epidermoid carcinoma).…”