title: Advanced sealing and dissecting devices in laparoscopic adrenal surgery.
abstract: OBJECTIVE
  This study sought to analyze the impact of advanced sealing/dissecting devices on operative and postoperative outcomes in laparoscopic adrenalectomy.
  
  
  METHODS
  Patients were divided into three groups according to the devices used during their procedures [electrothermal bipolar vessel system (EBVS), ultrasound shears (US), and monopolar electrocautery (ME)]. A comparison of the perioperative outcomes was performed.
  
  
  RESULTS
  Conversion rates and intraoperative and postoperative complication rates did not differ among the three groups. Major blood loss that required transfusion was registered in only two cases, all of which were performed with ME. Procedures with EBVS were shorter than those with US or ME. For left adrenalectomies only, operative times were similar for US and EBVS. The use of EBVS was found to be an independent predictor of decreased operative time.
  
  
  CONCLUSIONS
  The use of advanced sealing devices was associated with reduced operative time, with particular benefits in left adrenalectomy. EBVS and US may provide better hemostasis than ME.
authors.affiliation: Surgical Clinic, Department of Medical and Experimental Sciences, University of Brescia, Pl.e Spedali Civili 1, Brescia, Italy. leonardosolaini@gmail.com.
authors.forename: Leonardo
authors.initials: L
authors.lastname: Solaini
authors.affiliation: Surgical Clinic, Department of Medical and Experimental Sciences, University of Brescia, Brescia, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Arru
authors.affiliation: Surgical Clinic, Department of Medical and Experimental Sciences, University of Brescia, Brescia, Italy.
authors.forename: Giulia
authors.initials: G
authors.lastname: Merigo
authors.affiliation: Surgical Clinic, Department of Medical and Experimental Sciences, University of Brescia, Brescia, Italy.
authors.forename: Matteo
authors.initials: M
authors.lastname: Tomasoni
authors.affiliation: Surgical Clinic, Department of Medical and Experimental Sciences, University of Brescia, Brescia, Italy.
authors.forename: Federico
authors.initials: F
authors.lastname: Gheza
authors.affiliation: Surgical Clinic, Department of Medical and Experimental Sciences, University of Brescia, Brescia, Italy.
authors.forename: Guido Alberto Massimo
authors.initials: GA
authors.lastname: Tiberio
mesh_terms: D000315:Adrenalectomy / Q000295:instrumentation* / Q000379:methods*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004564:Electrocoagulation / Q000295:instrumentation*; D004598:Electrosurgery / Q000295:instrumentation*; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000295:instrumentation*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012189:Retrospective Studies; D059708:Ultrasonic Surgical Procedures / Q000295:instrumentation*; D055815:Young Adult