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Surgical Endoscopy
Published in: Surgical Endoscopy 10/2012

01-10-2012

Radiofrequency versus ultrasonic energy in laparoscopic colorectal surgery: a metaanalysis of operative time and blood loss

Authors: Nicola Di Lorenzo, Luana Franceschilli, Marco Ettore Allaix, Anastasios Asimakopoulos, Pierpaolo Sileri, Achille L. Gaspari

Published in: Surgical Endoscopy | Issue 10/2012

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Abstract

Background

Various energy sources are available for tissue dissection and vessel sealing in laparoscopic colorectal surgery. The electrothermal bipolar vessel sealing system (EBVS) and ultrasonic energy (UE) devices are widely used to provide hemostatic dissection in laparoscopic procedures. Nevertheless, available evidenced-based data comparing their operative results still are scarce. This study conducted a metaanalysis of controlled clinical trials comparing EBVS and UE in terms of operative time and intraoperative blood losses in laparoscopic colorectal surgery

Methods

The MEDLINE and Embase databases were searched using medical subject headings and free text words. All randomized controlled trials (RCTs) and controlled clinical trials using EBVS and UE in laparoscopic colorectal surgery were considered for inclusion in the study. Random effects models were used in case of heterogeneity to obtain summary statistics for the overall difference in operating time and blood loss between instruments.

Results

Four studies comparing EBVS with UE for 397 patients (200 EBVS vs. 197 UE patients) were included in the study. The findings showed that EBVS was associated with a significantly shorter operative time and less intraoperative blood loss than UE (p < 0.05).

Conclusions

The metaanalysis indicated that EBVS is associated with a shorter operative time and less blood loss than UE in laparoscopic colorectal surgery. However, these results should be interpreted with caution due to the high heterogeneity of the included trials and the limited number of studies with a high level of evidence. More adequately designed RCTs with a larger number of patients are required to confirm the results of this metaanalysis.
Literature
1.
Shin T, Rafferty JF (2010) Laparoscopy for benign colorectal diseases. Clin Colon Rectal Surg 23:42–50PubMedCrossRef
2.
Jayne DG, Thorpe HC, Copeland J, Quirke P, Brown JM, Guillou PJ (2010) Five-year follow-up of the Medical Research Council CLASICC trial of laparoscopically assisted versus open surgery for colorectal cancer. Br J Surg 97:1638–1645PubMedCrossRef
3.
Colon Cancer Laparoscopic or Open Resection Study Group, Buunen M, Veldkamp R, Hop WC, Kuhry E, Jeekel J, Haglind E, Påhlman L, Cuesta MA, Msika S, Morino M, Lacy A, Bonjer HJ (2009) Survival after laparoscopic surgery versus open surgery for colon cancer: long-term outcome of a randomised clinical trial. Lancet Oncol 10:44–52PubMedCrossRef
4.
Bennett CL, Stryker SJ, Ferreira MR, Adams J, Beart RW Jr (1997) The learning curve for laparoscopic colorectal surgery: preliminary results from a prospective analysis of 1,194 laparoscopic assisted colectomies. Arch Surg 132:41–44PubMedCrossRef
5.
Sardinha TC, Wexner SD (1998) Laparoscopy for inflammatory bowel disease: pros and cons. World J Surg 22:370–374PubMedCrossRef
6.
Nduka CC, Super PA, Monson JR, Darzi AW (1994) Cause and prevention of electrosurgical injuries in laparoscopy. J Am Coll Surg 179:161–170PubMed
7.
Grosskinsky CM, Hulka JF (1995) Unipolar electrosurgery in operative laparoscopy: capacitance as a potential source of injury. J Reprod Med 45:549–552
8.
Heniford BT, Matthews BD, Sing RF, Backus C, Pratt B, Greene FL (2001) Initial results with an electrothermal bipolar vessel sealer. Surg Endosc 15:799–801PubMedCrossRef
9.
Harold KL, Pollinger H, Matthews BD, Kercher KW, Sing RF, Heniford BT (2003) Comparison of ultrasonic energy, bipolar thermal energy, and vascular clips for the hemostasis of small-, medium-, and large-sized arteries. Surg Endosc 17:1228–1230PubMedCrossRef
10.
Amaral JF (1994) The experimental development of an ultrasonically activated scalpel for laparoscopic use. Surg Laparosc Endosc 4:92–99PubMed
11.
Emam TA, Cuschieri A (2003) How safe is high-power ultrasonic dissection? Ann Surg 237:186–191PubMed
12.
Siestes C, Eijsbouts QAJ, von Blomberg BM, Cuesta MA (2001) Ultrasonic energy vs monopolar electrosurgery in laparoscopic cholecystectomy: influence on the postoperative systemic immune response. Surg Endosc 15:69–71CrossRef
13.
Layock WS, Trus TL, Hunter JG (1996) New technology for the division of host gastric vessels during laparoscopic Nissen fundoplication: a prospective randomized trial. Surg Endosc 10:71–73CrossRef
14.
Pautler SE, Choyke P, Pavlovich CP, Daryanani K, Walther MM (2002) Intraoperative ultrasound aids in dissection during laparoscopic partial adrenalectomy. J Urol 168:1352–1355PubMedCrossRef
15.
Foschi D, Cellerino P, Corsi F, Taidelli T, Morandi E, Rizzi A, Trabucchi E (2002) The mechanism of blood vessel closure in humans by the application of ultrasonic energy. Surg Endosc 16:814–819PubMedCrossRef
16.
LeeWJ Chen TC, Lai IR, Huang MT, Wang W (2003) Randomized clinical trial of LigaSure versus conventional surgery for extended gastric cancer resection. Br J Surg 90:1493–1496CrossRef
17.
Moher D, Liberati A, Tetzlaff J, Altman DG, The PRISMA Group (2009) Preferred reporting items for systematic reviews and meta-analyses: The PRISMA Statement. PLoS Med 6(7):e1000097
18.
Campagnacci R, de Sanctis A, Baldarelli M, Rimini M, Lezoche G, Guerrieri M (2007) Electrothermal bipolar vessel sealing device vs ultrasonic coagulating shears in laparoscopic colectomies: a comparative study. Surg Endosc 21:1526–1531PubMedCrossRef
19.
Takada M, Ichihara T, Kuroda Y (2005) Comparative study of electrothermal bipolar vessel sealer and ultrasonic coagulating shears in laparoscopic colectomy. Surg Endosc 19:226–228PubMedCrossRef
20.
Hubner M, Demartines N, Muller S, Dindo D, Clavien P-A, Hahnloser D (2008) Prospective randomized study of monopolar scissors, bipolar vessel sealer, and ultrasonic shears in laparoscopic colorectal surgery. Br J Surg 95:1098–1104PubMedCrossRef
21.
Rimonda R, Arezzo A, Garrone C, Allaix ME, Giraudo G, Morino M (2009) Electrothermal bipolar vessel sealing system vs harmonic scalpel in colorectal laparoscopic surgery: a prospective, randomized study. Dis Colon Rectum 52:657–661PubMedCrossRef
22.
Targarona EM, Balague C, Marin J, Neto RB, Martinez C, Garriga J et al (2005) Energy sources for laparoscopic colectomy: a prospective randomized comparison of conventional electrosurgery, bipolar computer-controlled electrosurgery, and ultrasonic dissection: operative outcome and costs analysis. Surg Innov 12:339–344PubMedCrossRef
23.
Diamantis T, Kontos M, Arvelakis A, Syroukis S, Koronarchis D, Papalois A, Agapitos E, Bastounis E, Lazaris AC (2006) Comparison of monopolar electrocoagulation, bipolar electrocoagulation, Ultracision, and LigaSure. Surg Today 36(10):908–913PubMedCrossRef
24.
Morino M, Rimonda R, Allaix ME, Giraudo G, Garrone C (2005) Ultrasonic versus standard electric dissection in laparoscopic colorectal surgery: a prospective randomized clinical trial. Ann Surg 242:897–901PubMedCrossRef
25.
Marcello PW, Roberts PL, Rusin LC, Holubkov R, Schoetz DJ (2006) Vascular pedicle ligation techniques during laparoscopic colectomy: a prospective randomized trial. Surg Endosc 20:263–269PubMedCrossRef
26.
Hubner M, Hahnloser D, Hetzer F, Muller MK, Clavien PA, Demartines N (2007) A prospective randomized comparison of two instruments for dissection and vessel sealing in laparoscopic colorectal surgery. Surg Endosc 21:592–594PubMedCrossRef
27.
Kinoshita T, Kanehira E, Omura K, Kawakami K, Watanabe Y (1999) Experimental study on heat production by a 23.5-kHz ultrasonically activated device for endoscopic surgery. Surg Endosc 13:621–625PubMedCrossRef
28.
Kim FJ, Chammas MF Jr, Gewehr E, Morihisa M, Caldas F, Hayacibara E, Baptistussi M, Meyer F, Martins AC (2008) Temperature safety profile of laparoscopic devices: harmonic ACE (ACE), LigaSure V (LV), and plasma trisector (PT). Surg Endosc 22:1464–1469PubMedCrossRef
29.
Song C, Tang B, Campbell PA, Cuschieri A (2009) Thermal spread and heat absorbance differences between open and laparoscopic surgeries during energized dissections by electrosurgical instruments. Surg Endosc 23:2480–2487PubMedCrossRef
30.
Macario A, Dexter F, Sypal J, Cosgriff N, Heniford BT (2008) Operative time and other outcomes of the electrothermal bipolar vessel sealing system (LigaSure TM) versus other methods for surgical hemostasis: a meta-analysis. Surg Innov 15:284–291PubMedCrossRef
31.
Heili MJ, Flowers SA, Fowler DL (1999) Laparoscopic-assisted colectomy: a comparison of dissection techniques. JSLS 3:27–31
Metadata
Title
Radiofrequency versus ultrasonic energy in laparoscopic colorectal surgery: a metaanalysis of operative time and blood loss
Authors
Nicola Di Lorenzo
Luana Franceschilli
Marco Ettore Allaix
Anastasios Asimakopoulos
Pierpaolo Sileri
Achille L. Gaspari
Publication date
01-10-2012
Publisher
Springer-Verlag
Published in
Surgical Endoscopy / Issue 10/2012
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-012-2285-5

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