vessel sealing
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Obesity Facts ◽  
2021 ◽  
pp. 1-5
Author(s):  
Clara Boeker ◽  
Ibrahim A. Hakami ◽  
Julian Mall ◽  
Christian Reetz ◽  
Kamil Yamac ◽  
...  

Bariatric and metabolic surgery is currently the most effective procedure of achieving and maintaining weight loss. In the case under discussion, a 48-year-old male patient with heart insufficiency and an implanted left-ventricular assist device (LVAD) wanted to reduce his high BMI (48.6 kg/m<sup>2</sup>), so as to qualify for the heart transplant waiting list. According to the guidelines, he underwent all the required preoperative testing, which included psychosomatic clarifications, determination of endocrinological causes, and a nutritional consultation. During laparoscopic sleeve gastrectomy, a cardiac technician was present to support the anesthetist. After inserting 3 trocars with no complications, the greater curvature was mobilized using Medtronic’s bipolar electrothermal vessel-sealing instrument, LigaSure™. The resection was performed with an Ethicon™ endostapler. Postoperative monitoring showed no signs of hemorrhage. The patient’s BMI on the day of surgery was 46.8 kg/m<sup>2</sup> and consecutively fell to 26.7 kg/m<sup>2</sup> 1 year after the procedure. Follow-up appointments revealed that the patient was fit and in good health. Thus, the patient’s aim of being listed on the transplant list was fulfilled, and at the time of this writing, he is ready to be matched with an organ donor. Because high-BMI patients with inserted LVADs are less likely to receive a donor graft and must remain longer on transplant waiting lists than normal-weight patients, bariatric and metabolic weight loss surgery may lead to a speedier resolution for these high-risk patients.


2021 ◽  
Vol 38 (1) ◽  
Author(s):  
Mustafa Ulubay ◽  
Mehmet Ferdi Kıncı ◽  
Ramazan Erda Pay ◽  
Murat Dede

Objectives: To compare the use of Electrosurgical bipolar vessel sealing LigaSure™ small jaw instrument (LSJI) with conventional suture ligation in total abdominal hysterectomy (TAH). Methods: In this retrospective study 80 patients who underwent hysterectomy in the Gynecology and Obstetrics Department of Gulhane Education and Research Hospital between April 2017 and August 2018 were included. Two different groups that underwent Electrosurgical bipolar vessel sealing LigaSure™ small jaw instrument (LSJI) and conventional suture ligation in hysterectomy operation were analyzed retrospectively. The parameters evaluated and compared between the two groups include operation time, intraoperative blood loss, duration of hospitalization and incision length. Results: Among the parameters we compared between the two groups, there was no statistically significant difference between the amount of intraoperative blood loss (p:0.68) and the incision length (p:0.65). Among the parameters we compared between the two groups, a statistically significant difference was observed between the operation time (p:0.016) and the duration of hospitalization (p:0.01). Conclusion: Our comparison of LSJI vs. conventional ligation in hysterectomy revealed a significant difference only in operative time, where surgeries involving conventional ligation were shorter. On the other hand, incision length was evaluated in our study which has not been addressed in previous studies. There is also a need for multi-center studies that include more patients and evaluate cost-effectiveness. doi: https://doi.org/10.12669/pjms.38.1.4197 How to cite this:Ulubay M, Kinci MF, Pay RE, Dede M. Electrosurgical bipolar vessel sealing versus conventional clamping and suturing for total abdominal hysterectomy. Pak J Med Sci. 2022;38(1):---------. doi: https://doi.org/10.12669/pjms.38.1.4197 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


2021 ◽  
Vol 108 (Supplement_8) ◽  
Author(s):  
Wegdam Johannes ◽  
Dite de Jong ◽  
Simon Nienhuijs ◽  
Ellis Schipper ◽  
Elske Berkvens ◽  
...  

Abstract Aim Wound complications, like seromas and hematomas, occur in 23% after transversus abdominis release (TAR). Hemostat agents like fibrin glue have potential to reduce this rate, by vessel sealing and tissue bonding. But these are expensive. A topical hemostatic, like microporous polysaccharide hemospheres (MPH), is much cheaper, but its potential to reduce seromas and hematomas has never been analyzed in ventral hernia surgery. Material and Methods After the first 25 consecutive TAR patients (Control group, 2016-2018), MPH was introduced as an adjunct in a consecutive group of 25 TAR patients (Intervention group, 2019-2020). MPH was sprinkled in the TAR planes and subcutaneous tissue. Groups were compared. Results Pre-operative base-line characteristics and the overall complexity of the hernia patients and operations did not differ between the two groups. Postoperatively, the overall rate of surgical site occurrences (SSO) differed (CG:60%;IG:32%), but not significantly. Seromas (CG:5%;IG: 3%) and hematomas (CG:28%;IG:8%) did not differ significantly between the two groups. Medical complications (CG:13%;IG:10%) and two-year recurrence rate (CG:12%;IG:16%) also did not differ. Conclusions This study did not demonstrate a clear effect of MPH on the incidence of SSO, seromas or hematomas after a transversus abdominis release, despite the high incidence of wound complications in the first group of TAR patients (presumably, reflecting the learning curve of TAR). The fact that MPH does not glue tissue layers and minimize dead space, may be causative. MPH is not advised as an adjunct to reduce SSO.


2021 ◽  
Author(s):  
Christos Yiapanis ◽  
Ciprian Ober ◽  
Maria Potamopoulou ◽  
Theodoros Vasilakis ◽  
Joshua Milgram

Abstract Background: Canine orchiectomy involves making an incision in the prescrotal area, exteriorizing both testes via the same incision, ligating the blood vessels and spermatic cord, removing the testes, and suturing the incision. A briefer durations of anesthesia and surgery and decrease of postoperative morbidity could be obtain using a vessel sealing device. The aim of this study was to determine the feasibility and safety of orchiectomy in dogs by a scrotal approach with the use of a vessel-sealing device. Scrotal orchiectomy was performed with the use of monopolar electrosurgery device in pure cutting mode and a vessel-sealing device. Data were collected prospectively for the following categorical variables: breed, age, body weight, lifestyle, surgical time, indications for surgery and complications.Results: No complications were reported in 187 of 200 (93.5%). The complications documented were automutilation (AM), incisional complications (IC) and scrotal complications (SC). AM complications (11/200 [5.5%]) and SC complications (2/200 [1%]) were treated without additional surgery and resolved by day 10 after the surgery. Procedure duration (2,1 minutes± 0.4 minutes) was briefer than traditional castration duration reported in literature (3.5 ± 0.4 minutes).Conclusions: Results suggested that canine orchiectomy by scrotal approach with the use of a vessel-sealing device was feasible and safe. Furthermore, it was associated with a low complication rate and had the benefit of reduced surgical time and postoperative morbidity. This technique is promising for widespread application in veterinary surgery to help with haemostasis in canine orchiectomy.


Author(s):  
E Spartalis ◽  
A Giannakodimos ◽  
I Giannakodimos ◽  
A Ziogou ◽  
T Papasilekas ◽  
...  

INTRODUCTION Transient or permanent damage to the recurrent laryngeal nerve (RLN) during thyroidectomy is of paramount importance for patient quality of life. The aim of this study is to systematically review the literature concerning the role of the most popular energy-based vessel-sealing devices (LigaSure™ (LS) and Harmonic Scalpel (HS)) in preservation of the RLN during thyroidectomy. The safety and inferiority or superiority of LS and HS compared with conventional haemostatic techniques are highlighted. METHODS A systematic search of the literature was performed. Clinical trials, prospective and retrospective studies that significantly compared the use of LS and HS with conventional haemostasis regarding the postoperative incidence of RLN palsy were included. FINDINGS The search resulted in 43 studies, including 17,953 patients treated using energy-based devices or conventional haemostatic methods. Concerning the incidence of RLN palsy, 40 studies showed no significant difference between the energy-based device and conventional groups, whereas two studies demonstrated a significant superiority in performance for LS and HS compared with conventional haemostasis. Only one study exhibited significant inferiority of LS and HS compared with conventional methods. No statistical relationship was observed between energy-based devices and conventional techniques regarding permanent damage to the RLN. CONCLUSION The performance of both LS and HS shows no inferiority compared with conventional haemostatic techniques, regarding damage to the laryngeal nerve. Further well-designed studies are needed to investigate their potential benefit in preservation of the RLN.


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