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2007 Program and Abstracts | 2007 Posters
Performance of the Electrothermal Bipolar Vessel Sealer in 402 Consecutive Bowel Resections
William W. Hope*, William L. Newcomb, Thomas M. Schmelzer, Amy E. Lincourt, Ronald F. Sing, Kent W. Kercher, Keith S. Gersin, B Todd Heniford
Division of Gastrointestinal and Minimally Invasive Surgery, Carolinas Medical Center, Charlotte, NC

The electrothermal bipolar vessel sealer (EBVS) (LigasureTM, Valleylab, Boulder, CO) was developed as an alternative to sutures, clips, and the ultrasonic scalpel for hemostasis during open and laparoscopic surgery. The device creates a permanent seal by denaturing collagen in the vessel walls which forms a protein seal. The purpose of this prospective clinical study was to objectively evaluate the performance of the EBVS during intestinal surgery. Data from consecutive intestinal operations was collected prospectively from October 1998 to July 2006. All laparoscopic and open surgeries were included. The intention was to use the instrument to ligate all vessels (including major mesenteric arteries) encountered during all intestinal cases. The data collected included: total number of EBVS applications, need for additional hemostatic devices after application, estimated time savings or loss, and hemorrhagic complications.The EBVS was used in 402 colon and small bowel resections including 263 laparoscopic and 139 open operations. A total of 16,889 applications of the device were used averaging 42.0 applications per case. An additional suture ligature or clip was needed in only 0.8% of the total EBVS applications. In 305 intestinal resections no other means of hemostasis (sutures or clips) was required except the EBVS. The estimated average time saved using the EBVS was 24.1 (range: 5-60) minutes per case. One laparoscopic operation was converted to open surgery due to lack of control of bleeding. No patient required reoperation due to bleeding.The EBVS is safe and effective for colon and small intestinal resections in both open and laparoscopic cases. This novel energy source reliably seals major mesenteric vessels with little need for sutures or clips. Using the EBVS can substantially shorten operative time.

2007 Program and Abstracts | 2007 Posters
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