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Operative Time and Other Outcomes of the Electrothermal Bipolar Vessel Sealing System (LigaSure^TM) Versus Other Methods for Surgical Hemostasis: A Meta-Analysis

Departments of Anesthesia and Health Research & Policy, Stanford University School of Medicine, Stanford, California, Amaca{at}stanford.edu

Franklin Dexter, MD, PhD

Departments of Anesthesia and Health Management & Policy, University of Iowa

Jennifer Sypal, RN

Covidien, Energy-based Devices, Boulder, Colorado

Ned Cosgriff, MD

Covidien, Energy-based Devices, Boulder, Colorado

B. Todd Heniford, MD

Division of Gastrointestinal and Minimally Invasive Surgery, Carolinas Medical Center, Charlotte, North Carolina

A meta-analysis was performed of 29 prospective, randomized trials (published January 1, 2000, to August 14, 2007) comparing an electrothermal bipolar vessel sealing system (EBVS-LigaSure^TM, Covidien) (total n = 1107 patients) with either clamping with suture ligation/ electrocauterization (n = 1079 patients) or ultrasonic energy (eg, Harmonic Scalpel®, Johnson & Johnson). Hemorrhoidectomy (12 articles), hysterectomy (4 articles), and thyroidectomy (3 articles) were the most common procedures. For 15 of 26 studies reporting standard deviations, the normalized mean operative time reduction for EBVS equaled 28% (95% confidence interval [CI] 18%-39%, P < .0001) compared with conventional surgical hemostasis. Operative time was reduced with EBVS in 24 of 26 studies (P < .0001). EBVS was associated with 43 mL (95% CI 14-73 mL, P = .0021) less blood loss, fewer complications (odds ratio 0.66, 95% CI 0.47-0.92, P = .02), and mean reduction in postoperative pain of 2.8 units (95% CI 1.5-4.1, P < .0001). Five studies used ultrasonic energy as the comparator, but none reported standard deviation so data could not be pooled.

Key Words: operative time • surgical hemostasis • blood loss • pain scores • complications • electrothermal bipolar vessel sealing system

This version was published on December 1, 2008

Surgical Innovation, Vol. 15, No. 4, 284-291 (2008)
DOI: 10.1177/1553350608324933


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