Prospective randomized study of monopolar scissors, bipolar vessel sealer and ultrasonic shears in laparoscopic colorectal surgery.

Details

Serval ID
serval:BIB_9895C1ED60B0
Type
Article: article from journal or magazin.
Collection
Publications
Title
Prospective randomized study of monopolar scissors, bipolar vessel sealer and ultrasonic shears in laparoscopic colorectal surgery.
Journal
British Journal of Surgery
Author(s)
Hubner M., Demartines N., Muller S., Dindo D., Clavien P.A., Hahnloser D.
ISSN
1365-2168 (Electronic)
ISSN-L
0007-1323
Publication state
Published
Issued date
2008
Volume
95
Number
9
Pages
1098-1104
Language
english
Notes
Publication types: Comparative Study ; Journal Article ; Randomized Controlled TrialPublication Status: ppublish
Abstract
BACKGROUND: Many instruments are used for laparoscopic dissection, including monopolar electrosurgery scissors (MES), electrothermal bipolar vessel sealers (BVS) and ultrasonically coagulating shears (UCS). These three devices were compared with regard to dissection time, blood loss, safety and costs.
METHODS: Sixty-one consecutive patients undergoing laparoscopic left-sided colectomy were randomized to MES, BVS or UCS. The primary endpoint was dissection time.
RESULTS: Patient and operation characteristics did not differ between the groups. Median dissection time was significantly shorter with BVS (105 min) and UCS (90 min) than with MES (137 min) (P < 0.001). With BVS and UCS, significantly fewer additional clips were required (MES 9 versus BVS 0 versus UCS 3; P < 0.001) and there was a trend towards lower blood loss (125 versus 50 versus 50 ml respectively; P = 0.223) and a reduced volume of suction fluid (425 versus 80 versus 110 ml; P = 0.058). Overall satisfaction was similar for the three instruments. Dissection with BVS and UCS was significantly cheaper than with MES, assuming a centre volume of 200 cases per year (P = 0.009).
CONCLUSION: BVS and UCS shorten dissection time in laparoscopic left-sided colectomy and are cost-effective compared with MES.
Keywords
Adult, Aged, Aged, 80 and over, Attitude of Health Personnel, Colectomy/economics, Colectomy/instrumentation, Costs and Cost Analysis, Female, Humans, Laparoscopy/economics, Length of Stay, Male, Middle Aged, Prospective Studies, Surgical Instruments
Pubmed
Web of science
Create date
07/10/2014 15:23
Last modification date
20/08/2019 16:00
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