Laparoscopic-assisted colectomy: a comparison of dissection techniques.
OBJECTIVE
Mobilization of the colon and dissection of the mesentery are difficult laparoscopic techniques. Traditional methods have been used for this dissection, but often with great difficulty. The ultrasonically activated shears, when introduced in 1993, had the possibility to make this dissection less technically difficult. This is a retrospective review of the use of these shears for these techniques during laparoscopic-assisted colectomy.


METHODS
Eighty-five patients underwent a laparoscopic-assisted right hemicolectomy or sigmoid resection. Colon mobilization and mesenteric dissection were completed intracorporeally. Complications, operative time, estimated blood loss, and length of stay were compared for resections completed with and without the ultrasonically activated shears.


RESULTS
Thirty-six patients had laparoscopic-assisted colectomy without the shears, and 49 patients had the procedure with the shears. There were no complications due to the ultrasonic energy. Use of the shears resulted in shorter operative times (170 min. vs. 187 min., p=0.1989), similar median blood loss (98 mL vs. 95 mL, p=0.7620), and shorter lengths of stay (4.3 days vs. 6.9 days, p=0.0018).


CONCLUSIONS
The ultrasonically activated shears are safe and effective for colon mobilization and mesenteric division. The use of the shears may result in shorter operative times and shorter lengths of stay.
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003082:Colectomy / Q000379:methods*; D012809:Colon, Sigmoid / Q000601:surgery; D003108:Colonic Diseases / Q000601:surgery; D005260:Female; D006471:Gastrointestinal Hemorrhage; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D019106:Postoperative Hemorrhage; D012189:Retrospective Studies; D016896:Treatment Outcome