[Safety and efficacy of a new vessel-sealing device for laparoscopic varicocelectomy].
OBJECTIVE
To evaluate the safety and efficacy of a new vessel-sealing device (LigaSure) for laparoscopic varicocelectomy.


METHODS
To evaluate the safty, after elective varicocelectomy, the internal spermatic veins (n = 8) were sealed ex vivo with a 5-mm laparoscopic Maryland-style LigaSure (LigaSure Lap), and bursting pressures were measured. To evaluate the efficacy, a retrospective review of our clinical experience with LigaSure (n = 13) and clip (n = 13) in laparoscopic bilatelal varicocelectomy from June 2000 to October 2002 was performed and certain parameters were abstracted, including operative time, estimated blood loss and perioperative complications.


RESULTS
In the ex vivo study the mean varicocele vessele diameter was 2.5 +/- 0.8 mm (mean +/- SD) and bursting pressure was 449 +/- 95.2 mmHg. Six were burst in normal vessel walls at the average bursting pressure of 442 mmHg and two in the occlusions at the average bursting pressure of 508 mmHg. The difference was not statistically significant. Reliable vessel sealing was achieved in all the patients. The mean operative time showed significant decrease in the LigaSure group compared with the clip group, 70 +/- 20 minutes versus 117 +/- 27 minutes (p < 0.05). Estimated blood loss was minimal and no perioperative complications occurred in both groups.


CONCLUSIONS
Our study suggests that a vessel-sealing device appears to be a safe and feasible alternative to the clip in laparoscopic varicocelectomy. It offers the advantage of reducing operative time.
Kiuchi
Hiroshi
H
Department of Urology, Osaka Central Hospital.
Koga
Minoru
M
Hirai
Toshiaki
T
Namba
Yukiomi
Y
Takeyama
Masami
M
D000328:Adult; D006801:Humans; D010535:Laparoscopy; D008026:Ligation; D008297:Male; D012189:Retrospective Studies; D013525:Surgical Instruments / Q000592:standards*; D013521:Urologic Surgical Procedures, Male / Q000379:methods; D014646:Varicocele / Q000601:surgery*; D014656:Vascular Surgical Procedures / Q000295:instrumentation*