title: Electrothermal bipolar vessel sealing system vs. harmonic scalpel in colorectal laparoscopic surgery: a prospective, randomized study.
abstract: OBJECTIVE
  This study was designed to compare the efficacy and safety of laparoscopic colorectal surgery performed with the aid of LigaSure vessel-sealing system or Ultracision.
  
  
  METHODS
  Patients eligible for elective laparoscopic right or left hemicolectomy or anterior resection of rectum were randomly assigned to either the use of Ligasure or Ultracision. The primary end point was intraoperative reduction of blood loss. Secondary end points were intraoperative and postoperative morbidity and operative time.
  
  
  RESULTS
  Between April 2005 and December 2006, 140 consecutive patients were included in the study (70 Ligasure and 70 Ultracision. We performed 31 right hemicolectomies, 69 left hemicolectomies, and 40 anterior resections of rectum. Blood loss was 109.6 ml (Ultracision 107.9 ml vs. Ligasure 111.2 ml, P value = 0.72). Intraoperative complication rate was 2.8 percent (Ultracision 1.4 percent vs. Ligasure 4.2 percent, P value < 0.01). Postoperative mortality was 0.7 percent. The overall conversion rate was 7.8 percent, 6 in the Ligasure group and 5 in the Ultracision group (P value = 0.09). Operative time, considered from pneumoperitoneum to minilaparotomy, was 115.7 minutes (Ultracision 114.8 minutes vs. Ligasure 116.3 minutes, P value = 0.89).
  
  
  CONCLUSIONS
  Results showed that Ligasure and Ultracision are both useful instruments for laparoscopic colorectal surgery with no significant difference in terms of intraoperative/postoperative morbidity and operative time. Choice of which technique to perform should be according to the surgeon's preference.
authors.affiliation: Department of Surgery, University of Torino, Torino, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Rimonda
authors.forename: Alberto
authors.initials: A
authors.lastname: Arezzo
authors.forename: Corrado
authors.initials: C
authors.lastname: Garrone
authors.forename: Marco Ettore
authors.initials: ME
authors.lastname: Allaix
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Giraudo
authors.forename: Mario
authors.initials: M
authors.lastname: Morino
mesh_terms: D000368:Aged; D016063:Blood Loss, Surgical / Q000517:prevention & control* / Q000706:statistics & numerical data; D003082:Colectomy / Q000295:instrumentation* / Q000379:methods; D004564:Electrocoagulation / Q000379:methods*; D005260:Female; D006488:Hemostasis, Surgical / Q000295:instrumentation*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012007:Rectum / Q000601:surgery*