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Clipless Hand-assisted Laparoscopic Total Colectomy Using LigaSure Atlas

2004; Kurume University School of Medicine; Volume: 51; Issue: 2 Linguagem: Inglês

10.2739/kurumemedj.51.105

1881-2090

Yasumi Araki, Toshihiro Noake, M. Kanazawa, Katsuhiro Yamada, KAZUYA MOMOSAKI, Yasuhiro Nozoe, AKEMI INOUE, Nobuya Ishibashi, Yutaka Ogata, Kazuo Shirouzu,

Enhanced Recovery After Surgery

Hand-assisted laparoscopic total colectomy for ulcerative colitis has allowed less invasive operations in acute severe colitis and poor risk, and has not yet been widely applied for the reason of prolong the operating time in comparison with open surgery. We present the advantages of the use of the LigaSure AtlasTM vessel sealing for vascular control during laparoscopic surgery . A retrospective study was conducted to compare 15 patients who underwent hand-assisted laparoscopic total colectomy using an ultrasonic coagulator from January 1988 to September 2002 (US group) with 18 patients who were operated using LigaSure AtlasTM (LS group) from October 2002 to December 2003. There was no significant difference in the background factors of patients between both groups. The operating time was 225±58min in the LS group and less than 280±105min in the US group. Intraoperative blood loss was 91±22ml in the LS group and less than 212±178ml in the US group. Postoperative bleeding did not occur in the LS group, but occurred in 1 patient in the US group (6.6%) and this patient required re-operation. Postoperative seroma formation in the abdomen was found in 3 patients of the US group (20%). The procedure using LigaSure AtlasTM reduced the operating time, intraoperative bleeding and operator's stress in comparison with standard ultrasonic coagulation.