title: Literature review of the energy sources for performing laparoscopic colorectal surgery.
abstract: Laparoscopic surgery for colorectal disease has become widespread as a minimally invasive treatment. This is important because the increasing availability of new devices allows us to perform procedures with a reduced length of surgery and decreased blood loss. We herein report the results of a literature review of energy sources for laparoscopic colorectal surgery, focused especially on 6 studies comparing ultrasonic coagulating shears (UCS) and other instruments. We also describe our laparoscopic dissection techniques using UCS for colorectal cancer. The short-term outcomes of surgeries using UCS and Ligasure for laparoscopic colorectal surgery were superior to conventional electrosurgery. Some authors have reported that the length of surgery or blood loss when Ligasure was used for laparoscopic colorectal surgery is less than when UCS was used. On the other hand, a recent study demonstrated that there were no significant differences between the short-term outcomes of UCS and Ligasure for laparoscopic colorectal surgery. It is therefore suggested that the choice of technique used should be made according to the surgeon's preference. We also describe our laparoscopic dissection techniques using UCS (Harmonic ACE) for colorectal cancer with regard to the retroperitoneum dissection, dissection technique, dissection technique around the feeding artery, and various other dissection techniques. We therefore review the outcomes of using various energy sources for laparoscopic colorectal surgery and describe our laparoscopic dissection techniques with UCS (Harmonic ACE) for colorectal cancer.
authors.affiliation: Tsukasa Hotta, Katsunari Takifuji, Shozo Yokoyama, Kenji Matsuda, Takashi Higashiguchi, Toshiji Tominaga, Yoshimasa Oku, Takashi Watanabe, Toru Nasu, Tadamichi Hashimoto, Koichi Tamura, Junji Ieda, Naoyuki Yamamoto, Hiromitsu Iwamoto, Hiroki Yamaue, Second Department of Surgery, Wakayama Medical University, School of Medicine, Wakayama 641-8510, Japan.
authors.forename: Tsukasa
authors.initials: T
authors.lastname: Hotta
authors.forename: Katsunari
authors.initials: K
authors.lastname: Takifuji
authors.forename: Shozo
authors.initials: S
authors.lastname: Yokoyama
authors.forename: Kenji
authors.initials: K
authors.lastname: Matsuda
authors.forename: Takashi
authors.initials: T
authors.lastname: Higashiguchi
authors.forename: Toshiji
authors.initials: T
authors.lastname: Tominaga
authors.forename: Yoshimasa
authors.initials: Y
authors.lastname: Oku
authors.forename: Takashi
authors.initials: T
authors.lastname: Watanabe
authors.forename: Toru
authors.initials: T
authors.lastname: Nasu
authors.forename: Tadamichi
authors.initials: T
authors.lastname: Hashimoto
authors.forename: Koichi
authors.initials: K
authors.lastname: Tamura
authors.forename: Junji
authors.initials: J
authors.lastname: Ieda
authors.forename: Naoyuki
authors.initials: N
authors.lastname: Yamamoto
authors.forename: Hiromitsu
authors.initials: H
authors.lastname: Iwamoto
authors.forename: Hiroki
authors.initials: H
authors.lastname: Yamaue