title: Ultrasonic shear coagulation of main hilar vessels: A 4-year experience of 23 pediatric laparoscopic splenectomies without staples.
abstract: BACKGROUND
  Ultrasonic shears (LCS) are used increasingly for laparoscopic splenectomy. So far however, all investigators use vascular staplers or clips for section of the main splenic artery and vein.
  
  
  METHODS
  After several trials the authors started to use the ultrasonic triple welding technique in open surgery to occlude major vessels of 5 to 8 mm by 10-mm LCS. In June 1997 the authors introduced triple welding into laparoscopic splenectomy to mobilize the complete spleen by LCS.
  
  
  RESULTS
  There was no hemorrhage in 23 laparoscopic splenectomies performed exclusively by LCS and no complications except 1 port site hernia.
  
  
  CONCLUSIONS
  Laparoscopic splenectomy entirely by reusable LCS without clips and stapler is a safe, simple, and inexpensive technique. Moreover, the policy of "leaving nothing back" is an attractive strategy in endoscopic pediatric surgery.
authors.affiliation: Helios Center of Pediatric Surgery, Berlin-Buch, Germany.
authors.forename: Klaus
authors.initials: K
authors.lastname: Schaarschmidt
authors.forename: Andreas
authors.initials: A
authors.lastname: Kolberg-Schwerdt
authors.forename: Michael
authors.initials: M
authors.lastname: Lempe
authors.forename: Amulya
authors.initials: A
authors.lastname: Saxena
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D006488:Hemostasis, Surgical / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D013156:Splenectomy / Q000379:methods*; D013157:Splenic Artery / Q000601:surgery; D013162:Splenic Vein / Q000601:surgery; D013525:Surgical Instruments; D013537:Sutures; D014464:Ultrasonic Therapy / Q000379:methods*