Use of the Electrothermal Vessel Sealing System Versus Standard Vessel Ligation in Thyroidectomy

Shen, Wen T.; Baumbusch, Margaret A.; Kebebew, Electron; Duh, Quan‐Yang

doi:10.1016/s1015-9584(09)60268-2

Cited by 65 publications

(40 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Several authors reported a reduction in complications such as transient recurrent palsy and transient hypoparathyroidism and shorter operating times, 12 whereas others reported a shorter operating time but no change in the incidence of complications. [13][14][15] Some authors even reported no difference in operating times or the incidence of complications between LigaSure and traditional hemostatic methods. We began using LigaSure in thyroidectomy in 2002.…”

mentioning

confidence: 99%

“…Several authors 14,15 maintain that LigaSure is suitable for use in hemithyroidectomy, since it makes separating the thyroid gland tissue easier than traditional methods of ligation, thereby reducing the operating time to about 20 min. We do agree that the device may be faster and more effi cient in the early phases of the operation: for coagulating the external jugular veins, for preparing fl aps by separating the platysma, and for separating the strap muscles along the linea alba.…”

mentioning

confidence: 99%

See 1 more Smart Citation

LigaSure in total thyroidectomy

et al. 2008

View full text Add to dashboard Cite

Purpose. LigaSure is a bipolar diathermy system, which achieves vessel sealing with reduced thermal spread. The device has been used successfully in abdominal operations and because of its features, it has been applied recently in thyroid surgery to minimize the risk of complications such as laryngeal nerve palsy and hypocalcemia, and also to reduce the operating time. Methods. Between June and December 2005, we performed total thyroidectomy for various disorders in 105 patients. We used the LigaSure diathermy system in 53 patients and traditional hemostatic procedures in the other 52. We evaluated the demographic features, histopathological diagnosis, operating times, and relevant postoperative complications. Results. The two study groups had similar demographic and histopathological features. The mean operating time ± SD was not signifi cantly shorter in the LigaSure group than in the traditional group (104 ± 12.7 vs 110 ± 15.6 min). None of the patients in either group suffered hemorrhage, defi nitive hypocalcemia, or defi nitive laryngeal nerve palsy. Transient hypocalcemia and transient laryngeal nerve palsy developed in 7.54% and in 1.88%, respectively, of the patients in the LigaSure group, and in 7.69% and 1.92%, respectively, of the patients in the traditional group; these differences were not signifi cant. Conclusions. LigaSure is a safe and effective method of hemostasis control, but it did not reduce the incidence of complications or operating times compared with traditional hemostatic procedures; moreover, the operative costs were higher.

show abstract

mentioning

confidence: 99%

mentioning

confidence: 99%

LigaSure in total thyroidectomy

et al. 2008

View full text Add to dashboard Cite

show abstract

“…De esta forma, si se consideran las cirugías realizadas por los cirujanos del equipo existe una leve disminución en el tiempo operatorio de los pacientes operados con Ligasure, similar a otros reportes internacionales 9 . El hematoma que se presentó en el grupo de Ligasure correspondió a un paciente añoso con arteriosclerosis de Monckeberg confirmada histológicamente.…”

Section: Resultsunclassified

“…Esto, en contraste con el alto costo inicial de la máquina y el costo por cada paciente en el uso de Ligasure, por lo que sólo sería beneficioso en centros que operan un alto número de tiroidectomías al año (> 100) 8,9 . Basados en los resultados expuestos creemos que la tiroidectomía con técnica de sellado de vasos con Ligasure Precise es un método posible de realizar en nuestro medio, siendo tan seguro como la tiroidectomía con ligaduras.…”

Section: Resultsunclassified

Tiroidectomia sin ligaduras: evaluando Ligasure Precise®

Amat

et al. 2008

Rev Chil Cir

View full text Add to dashboard Cite

RESUMENIntroducción: En tiroidectomía total se están evaluando métodos de hemostasia distintos a la ligadura habitual. Objetivo: Presentar nuestra experiencia inicial en la tiroidectomía total sin ligaduras, al utilizar el método de sellado de vasos a través de Ligasure Precise ® . Material y método: Se consignaron en forma prospectiva, los datos de 129 pacientes: Datos personales, fecha de operación, antecedentes mórbidos, síntomas, función tiroidea, examen físico, ecografía, punción con aguja fina, tipo de operación, cirujano, tiempo operatorio, estadía postoperatoria, débito de drenajes, biopsia intraoperatoria y definitiva, complicaciones. Se utilizó un p < 0.05 como significativo para los cálculos estadísticos. Resultados: Se realizaron 129 tiroidectomías entre Enero y Agosto del 2005. Se operaron 65 pacientes de forma tradicional y 64 con Ligasure. No hubo mortalidad operatoria. Edad promedio 42,7 y 46,9 para cada grupo (p >0.05). Biopsia definitiva informó carcinoma en 34 y 32 % respectivamente. Hospitalización promedio de 2,63 días y 2,26 días (p 0.02). El débito de drenajes fue 78 cc para el grupo Ligasure y 63,2 cc para el grupo tradicional. Tiempo operatorio promedio de 94 minutos (grupo tradicional) y 92 minutos (Ligasure) (p= 0.6). Las complicaciones fueron hematoma (1 caso por grupo), Lesión de recurrente laríngeo (1 caso en el grupo de ligadura tradicional) e hipocalcemia transitoria (6 casos en el grupo Ligasure y 1 caso en el grupo control). Conclusión: La tiroidectomía con Ligasure Precise es un método cómodo para el cirujano y tan seguro como la tiroidectomía con ligaduras. Su aplicación, indicación y reales beneficios deben ser evaluados en el futuro con mayor número de casos.PALABRAS CLAVE: Tiroidectomía, Ligasure, hemostasia. SUMMARYBackground: Traditionally, hemostasis during thyroidectomy is done using clamp ligation of vessels. There is a new hemostasis method based on thermal coagulation and pressure that be used in this type of surgery. Aim: To report the experience with Ligasure Precise ® thermal hemostasis system. Material and methods: Prospective evaluation of patients subjected to thyroidectomy with or without the use of Ligasure ® . The choice of patients for each type of hemostasis was not randomized. Operative time, surgical complications and postoperative evolution were assessed. Results: During the study period, 64 patients

show abstract

“…This is mostly due to imperfect haemostasis as well as the damage to adjacent organs, firstly the nerves. Wide application of the latest techniques provided notable decrease of both intra-and postoperative complication rate (Vassilios et al 2005, Shen et al 2005, Rosato et al 2004). Today, surgical dissection and tissue coagulation with monopolar and bipolar coagulation as well as LigaSure high frequency current generator (HFCG) are the surgical modalities of choice (Andreas 2004, Foster 1978, Dionigi et al 2006).…”

Section: Introductionmentioning

confidence: 99%

Morphologic Changes in the Nodular Goitre Induced by the Ligasure High Frequency Current Generator

Yermakova¹

2015

hpc

View full text Add to dashboard Cite

Summary: Today, surgical dissection and tissue coagulation with both monopolar and bipolar coagulation as well as LigaSure high frequency current generator (HFCG) are the surgical modalities of choice in the treatment of thyroid pathology. However, the question of the high frequency current effect on the morphofunctional condition of the posthemithyroidectomic parenchyma is still disputable. The goal of the research is a thorough histological analysis of the surgically removed thyroid tissue specimen. The nodular goitre of 50 patients was subject to the histological study. The surgery was performed with the LigaSure HFCG. The 1.0x0.5 thyroid tissue specimens were excised from three areas. Hemithyroidectomy lasted for 40-50 min and thyroidectomy -120 ± 4.2 min. In both procedures, the blood loss was within 70-150 ml, no haemorrhage being observed in both intra-and postoperative period. The zonal effect of high frequency current on the thyroid structure was determined morphologically, namely coagulation necrosis in the site of direct action, intensified secretory response of the thyroid tissue to the extremal factor in the perifocal area, and typical structure of the nodular goitre with the signs of impaired microcirculation in the remote area. Morphologic changes of the thyroid gland, with high frequency current used as a dissector, are distance-dependent.

show abstract

Use of the Electrothermal Vessel Sealing System Versus Standard Vessel Ligation in Thyroidectomy

Abstract: We found that the LigaSure was as safe as standard vessel ligation for thyroidectomy, with the benefit of reduced operating time. A future prospective study has been designed.

Cited by 65 publications

References 8 publications

LigaSure in total thyroidectomy

LigaSure in total thyroidectomy

Tiroidectomia sin ligaduras: evaluando Ligasure Precise®

Morphologic Changes in the Nodular Goitre Induced by the Ligasure High Frequency Current Generator

Contact Info

Product

Resources

About