title: Effectiveness of electrothermal bipolar vessel-sealing devices versus other electrothermal and ultrasonic devices for abdominal surgical hemostasis: a systematic review.
abstract: BACKGROUND
  Adequate hemostatic techniques are essential for optimal intra- and postoperative results. A number of different hemostatic techniques and devices have been developed over the past few years, but which device should be preferred during laparoscopic and open abdominal procedures?
  
  
  METHODS
  We conducted a systematic search for randomized controlled trials (RCTs) that compared the effectiveness and costs of vessel-sealing devices with those of other electrothermal or ultrasonic devices in abdominal surgical procedures.
  
  
  RESULTS
  Seven RCTs that included 554 patients met the inclusion criteria. Various procedures that used a vessel-sealing device (LigaSure™) (n = 264) were compared to ultrasonic devices (n = 139) and mono- (n = 20) or bipolar devices (n = 130). LigaSure was favored in two studies with respect to less blood loss, shorter operating time, and lower costs. However, no differences were observed in the other studies. Considering the relatively low number of complications, all hemostatic devices used may be considered relatively safe. None of the studies reported on quality of life or cost effectiveness.
  
  
  CONCLUSIONS
  Vessel-sealing devices may be considered safe and their use may reduce costs due to reduced blood loss and shorter operating time in some abdominal surgical procedures compared to mono- or bipolar electrothermal devices. Wider-ranging RCTs of sufficient quality that assess (cost) effectiveness are required to make firm conclusions.
authors.affiliation: Department of Obstetrics and Gynecology, VU University Medical Center, De Boelelaan 1117, 1181 HV, Amsterdam, The Netherlands. pfjanssen@hetnet.nl
authors.forename: Petra F
authors.initials: PF
authors.lastname: Janssen
authors.forename: Hans A M
authors.initials: HA
authors.lastname: Brölmann
authors.forename: Judith A F
authors.initials: JA
authors.lastname: Huirne
mesh_terms: D003362:Cost-Benefit Analysis; D004564:Electrocoagulation / Q000295:instrumentation*; D004869:Equipment Safety; D006488:Hemostasis, Surgical / Q000191:economics / Q000295:instrumentation*; D006801:Humans; D007902:Length of Stay; D016032:Randomized Controlled Trials as Topic; D013536:Suture Techniques; D014465:Ultrasonics / Q000295:instrumentation