'Use of electrothermal vessel sealing with LigaSure device during laparoscopic splenectomy'.

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Barbaros U., Deveci U.

ACTA CHIRURGICA BELGICA, cilt.107, sa.107, ss.162-165, 2007 (SCI-Expanded, Scopus)

Özet

Abstract. Purpose : Main causes of conversion to open surgery are uncontrolled bleeding from splenic hilum and

capsular injury of spleen during laparoscopic splenectomy (LS). We present the use of LigaSure™ in laparoscopic

splenectomy for hemostasis.

Material & Method : Between January 2005 and May 2006, LS was performed in a total of 29 patients (6 male and

23 female) with a mean age of 35.44 ± 13.63. Indications for splenectomy were idiopathic thrombocytopenic purpura

(ITP) in 20 patients, thrombotic thrombocytopenic purpura (TTP) in 2, hereditary spherocytosis (HS) in 3, lymphangioma

in 2, hodgkin lymphoma in 1 and splenic cyst in one patient. LS was performed in the right semilateral position

with three 10 mm trocars. LigaSure™ was used in dissection and division of splenic ligaments and hilar vascular

structures.

Results : Conversion to open surgery was necessary in one patient due to peroperative bleeding. The mean duration of

the operation was 71.3 ± 19.8 minutes and the estimated blood loss was 85 ± 23 ml. The diameter and the weight of the

spleen were 10.7 ± 2.68 cm and 250 ± 90 g, respectively. There was no mortality. Postoperative complications included

pancreatic fistula, trocar site infection and deep venous thrombosis that were encountered in three patients. These were

managed without morbidity. The overall complication rate was 10.3% (n = 3). The mean duration of postoperative

hospital stay was 2.86 ± 1.59 days.

Conclusion : LigaSure™ use in LS had easy application, provided sufficient hemostasis, and shortened the operative

time.