Laparoscopic sigmoid and rectal resection using an electrothermal bipolar vessel sealing device.
BACKGROUND
Laparoscopic colonic resection has gained popularity as a method to treat colonic diseases. The electrothermal bipolar vessel sealer (EBVS; LigaSure Atlas) is a modern device that allows the secure sealing of vessels with a diameter of up to 7 mm. The aim of the present study was to evaluate the suitability of the device for laparoscopic colonic surgery.


METHODS
The immediate outcome of 114 consecutive patients who underwent a sigmoid or rectal resection was prospectively analyzed. The intention was to perform all operations with the EBVS for dissection and ligation of the mesenterial vessels. Details on patient characteristics, peroperative and postoperative complications, and postoperative recovery were recorded prospectively and analyzed.


RESULTS
One hundred and fourteen patients were scheduled for elective left-sided colonic or rectal resection. Massive intra-abdominal adhesions in 1 patient required a conversion of the laparoscopic procedure to an open one; In total, 113 laparoscopic operations were thus performed. The mean operative time was 87.7 +/- 2.8 minutes, and the mean time for patients to tolerate solid food was 3.4 +/- 0.1 days and the time to discharge from hospital was 4.6 +/- 0.2 days. There were nine (8.0%) general complications, and additionally, 10.6% of patients suffered from surgical complications.


CONCLUSIONS
The electrothermal bipolar vessel sealer is suitable and safe for laparoscopic sigmoid and rectal resections. The use of the device probably reduces the operative time.
Kössi
Jyrki
J
Department of Surgery, Päijät-Häme Central Hospital, Lahti, Finland. jyrki.kossi@phks.fi
Luostarinen
Markku
M
Kontula
Ilpo
I
Laato
Matti
M
D001808:Blood Vessels; D012809:Colon, Sigmoid / Q000601:surgery*; D003108:Colonic Diseases / Q000601:surgery*; D004598:Electrosurgery / Q000295:instrumentation*; D005260:Female; D006489:Hemostatic Techniques / Q000295:instrumentation*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011446:Prospective Studies; D012007:Rectum / Q000601:surgery*; D016896:Treatment Outcome