New energy‐based devices in laparoscopic splenectomy: Comparison of Ligasure alone versus Ligasure and Ultracision together

Background: More effective energy‐based haemostatic devices, such as LigaSure and Ultracision, have made laparoscopic solid organ surgery, such as laparoscopic splenectomy (LS), feasible and have facilitated its advancement. The aim of the present study was to compare the effectiveness of Ligasure alone or Ligasure and Ultracision together in LS. Methods: Between February 2007 and August 2010, 25 consecutive adult patients (16 male, 9 female, mean age 35 years) who underwent LS with a wide range of immune trombositopenic purpura (ITP) were studied retrospectively. The patients were evaluated in two groups. The first group of 12 patients was the LigaSure group, and the second group of 13 patients was the LigaSure + Ultracision group. The two groups were compared according to operating time, blood loss and postoperative hospital stay. Groups were well matched according to age, sex, spleen size and weight, body mass index, converting and complication rate. Results: Mean operative time was significantly shorter for the LigaSure + Ultracision group versus the LigaSure group (112.3 vs 147.5 min; P = 0.002). Mean intraoperative blood loss was slightly lower for the LigaSure + Ultracision group vs the LigaSure group, but it was not statistically significant (122.3 vs 142.5 mL; P = 0.219). There was no significant difference in mean postoperative hospital stay for both groups (2.3 vs 2.9 days; P = 0.093). Conclusion: LS must be the first choice for removal of the spleen, particularly for benign haematological disorders. One of the most important factors to achieve advanced laparoscopic surgery, such as LS, is new energy‐based devices, such as LigaSure and Ultracision. Using LigaSure and Ultracision together in LS reduces the operating time.