Operative Time and Other Outcomes of the Electrothermal Bipolar Vessel Sealing System (LigaSure™) Versus Other Methods for Surgical Hemostasis: A Meta-Analysis

@article{Macario2008OperativeTA,
  title={Operative Time and Other Outcomes of the Electrothermal Bipolar Vessel Sealing System (LigaSure{\texttrademark}) Versus Other Methods for Surgical Hemostasis: A Meta-Analysis},
  author={Alex Macario and Franklin Dexter and Jennifer Sypal and Ned Cosgriff and B. Todd Heniford},
  journal={Surgical Innovation},
  year={2008},
  volume={15},
  pages={284 - 291}
}
A meta-analysis was performed of 29 prospective, randomized trials (published January 1, 2000, to August 14, 2007) comparing an electrothermal bipolar vessel sealing system (EBVS-LigaSure™, Covidien) (total n = 1107 patients) with either clamping with suture ligation/ electrocauterization (n = 1079 patients) or ultrasonic energy (eg, Harmonic Scalpel®, Johnson & Johnson). Hemorrhoidectomy (12 articles), hysterectomy (4 articles), and thyroidectomy (3 articles) were the most common procedures… 
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The present meta-analysis indicated superiority of Harmonic Scalpel only in terms of surgical time compared with LigaSure hemostasis techniques in open thyroid surgery.
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References

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Hepatic resections by means of electrothermal bipolar vessel device (EBVS) LigaSure V: early experience
TLDR
EBVS proved to be safe and effective for liver resection by means of this device, statistically significant benefits concerning blood loss, total bile salts, and hemoglobin postoperative leakage were found.
Comparative study of electrothermal bipolar vessel sealer and ultrasonic coagulating shears in laparoscopic colectomy
TLDR
The use of the EBVS will enable surgeons to reduce the total operating time for laparoscopic colectomy and the required time for mesocolon dissection was significantly shorter when the EB VS was used in both laparosc transverse coLECTomy and sigmoidectomy.
A comparison of laparoscopic bipolar vessel sealing devices in the hemostasis of small-, medium-, and large-sized arteries.
TLDR
The LS produces supraphysiologic seals with significantly higher bursting pressures than the PK in vessels ranging from 4 to 7 mm, and although thermal spread increases with vessel size, the degree of lateral thermal injury is no different between the two instruments.
Use of the electrothermal bipolar vessel system (EBVS) in laparoscopic adrenalectomy: a prospective study
TLDR
EBVS in LA may provide a significantly short operating time and blood loss and the main surgical parameters collected concerned operative time, major and minor complications, conversion rate, blood loss, hospital stay and histology.
Comparison of ultrasonic energy, bipolar thermal energy, and vascular clips for the hemostasis of small-, medium-, and large-sized arteries
TLDR
The EBVS can be used confidently in vessels up to 7 mm, and the spread of thermal injury from the UCS and the EBVS was compared, with no difference in the thermal spread of the LigaSure vessel sealer and the UCS.
Effectiveness of the ultrasonic coagulating shears, LigaSure vessel sealer, and surgical clip application in biliary surgery: a comparative analysis.
TLDR
The ultrasonic coagulating shears and electrothermal bipolar vessel sealer failed to maintain seal integrity in the in vivo animal study and should not be used for transection of the cystic duct or major hepatic ducts during hepatobiliary surgery.
Vascular pedicle ligation techniques during laparoscopic colectomy. A prospective randomized trial.
TLDR
The LigaSure Atlas is more cost effective during laparoscopic colectomy, especially total colectome, and may allow the surgeon more versatility in its application.
Energy Sources for Laparoscopic Colectomy: A Prospective Randomized Comparison of Conventional Electrosurgery, Bipolar Computer-Controlled Electrosurgery and Ultrasonic Dissection. Operative Outcome and Costs Analysis
TLDR
Surgical time was significantly longer in patients operated on with conventional electrosurgery vs the Harmonic Scalpel or computed-based bipolar energy devices, and this finding correlated with a significant reduction in intraoperative blood loss.
Ligasure versus sutures in bladder replacement with Montie ileal neobladder after radical cystectomy.
  • P. Manasia, A. Alcaraz, J. Alcover
  • Medicine
    Archivio italiano di urologia, andrologia : organo ufficiale [di] Societa italiana di ecografia urologica e nefrologica
  • 2003
TLDR
Ligasure is a safe and effective alternative to sutures in cystectomy and bladder replacement, resulting in decreased blood loss and significant time saving.
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