title: Randomized clinical trial of ligasure™ versus conventional splenectomy for injured spleen in blunt abdominal trauma.
abstract: BACKGROUND
  Spleen is the most common organ damaged in cases of blunt abdominal trauma and splenectomy and splenorrhaphy are the main surgical procedures that are used in surgical treatment of such cases. In routine open splenectomy cases, after laparotomy, application of sutures in splenic vasculature is the most widely used procedure to cease the bleeding. This clinical trial evaluates the role and benefits of the Ligasure™ system in traumatic splenectomy without using any suture materials and compares the result with conventional method of splenectomy.
  
  
  METHODS
  After making decision for splenectomy secondary to a blunt abdominal trauma, patients in control group (39) underwent splenectomy using conventional method with silk suture ligation of splenic vasculature. In the interventional group (41) a Ligasure™ vascular sealing system was used for ligating of the splenic vein and artery. The results of operation time, volume of intra-operation bleeding and post-operative complications were compared in both groups.
  
  
  RESULTS
  The mean operation times in control and interventional group were 21 and 12 min respectively (p < 0.05). The average volume of bleeding in control group during open splenectomy was 280 cc, but in the interventional group decreased significantly to 80 ml (p < 0.05) using the Ligasure system. Post-operative complications such as bleeding were non-existent in both groups.
  
  
  CONCLUSIONS
  The application of Ligasure™ in blunt abdominal trauma for splenectomy not only can decrease the operation time but also can decrease the volume of bleeding during operation without any additional increase in post-operative complications. This method is recommendable in traumatic splenic injuries that require splenectomy in order to control the bleeding as opposed to use of traditional silk sutures.
authors.affiliation: Birjand University of Medical Sciences, General Surgery Department, Imam Reza Hospital, Taleghany St, Birjand, South Khosrasan, Iran. Electronic address: vejdan_sa@yahoo.com.
authors.forename: Vejdan Seyyed
authors.initials: VS
authors.lastname: Amirkazem
authors.affiliation: Birjand University of Medical Sciences, Anesthesiology Department, Imam Reza Hospital, Taleghany St, Birjand, South Khosrasan, Iran. Electronic address: Khosravi.malihe@yahoo.com.
authors.forename: Khosravi
authors.initials: K
authors.lastname: Malihe
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006470:Hemorrhage / Q000209:etiology; D006801:Humans; D007813:Laparotomy; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D011183:Postoperative Complications / Q000601:surgery; D012421:Rupture / Q000601:surgery; D013154:Spleen / Q000098:blood supply / Q000293:injuries* / Q000601:surgery; D013156:Splenectomy / Q000379:methods*; D013157:Splenic Artery / Q000601:surgery*; D013162:Splenic Vein / Q000601:surgery*; D000071062:Sutureless Surgical Procedures / Q000295:instrumentation / Q000379:methods*; D014949:Wounds, Nonpenetrating / Q000150:complications / Q000601:surgery*; D055815:Young Adult
keywords: Ligasure; Splenectomy; Trauma