How does ligasure work

It involves clamping on tissue which compresses the vessel walls. The current then begins to flow through tissue, thereby, creating heat. Native tissue proteins denature while water turns to vapor and escapes. LigaSure technology fuses the internal walls of the vessels resulting in complete luminal occlusion.

Operating performance is significantly amplified by this technology as it has been found to have the highest burst pressure and fastest sealing time.

Hence, it reduces more procedure time, patient length of stay, and blood loss compared to sutures and clips. It also reduces the cost of disposable surgical supplies as it does not require multiple reloadable cartridges. It also offers minimal sticking, tissue charring, and thermal spread, unlike standard bipolar, and monopolar electrosurgery. What is an ultrasound transducer? Musella et al. Musella, M. Milone, P. Maietta et al. S69—S72, Altieri, B.

Wright, A. Peredo, and A. Di Minno, R. Lupoli et al. Galloro, S. Ruggiero, T. Russo et al. Galloro, L. Magno, M. Musella, R. Manta, A. Zullo, and P. Milone, N. Velotti, and M. Scarano, M. Di Minno et al. Meurisse, T. Defechereux, S. Maweja, C. Degauque, M. Vandelaer, and E. Di Minno, M. Mastronardi et al. Baker, J. Foote, P.

Kemmeter, R. Brady, T. Vroegop, and M. Bellini, M. Leongito, R. Guarino, and F. Do we need to oversew the staple line? View at: Google Scholar M. Maietta, P. Bianco, A. Pisapia, and D. Maietta, M. Coretti et al. S—S, Guida, M. Cataldi, L. Busetto et al. Musella, V. Our study was designed to evaluate the LigaSure procedure in parotid gland surgery. The data emerging from this investigation reveal advantages of the LigaSure procedure over traditional methods concerning operative procedures and operative time only.

No significant differences were reported between the 2 groups regarding complications, facial palsy or weakness, and duration of hospital stay.

The LigaSure Precise has thinner tips than the standard LigaSure instrument, and in parotid gland surgery, it can be used as a dissector as well as a coagulator. This aspect could be the cause of the reduced operative time in total or superficial parotidectomy.

Use of the LigaSure system reduced the length of the operation to a mean of In all cases, the mean operative time was reduced by 15 minutes. The LigaSure Precise instrument shows some advantages because it reduces 1 adhesions and thermal spread and 2 the number of applications 1 is usually enough.

The absence of blood in the operative field is such that no time is required to secure hemostasis, resulting in the mean operating time decrease. Operative time depends not only on the size of the tumor but also on the tumor position, the pattern and size of the facial nerve branches, the training and experience of the surgeon, and the history of surgery in the area. In the present study, all superficial parotidectomies were performed by the same surgeon to control the variable of surgeon experience and training.

Moreover, the surgical team was the same in all cases. Regarding postoperative pain and the need for analgesia, there was no significant difference between groups in postoperative pain. Moreover, less local edema and the reduction or absence of necrosis of surrounding tissues have been noted. Owing to the minimal thermal spread, the incidence of facial nerve and other nerve branch palsy was low but comparable with that of the standard procedure.

A higher incidence 3 of 17 patients of salivary fistulas was recorded in group A. In the present study, we hypothesize that the LigaSure device produced a smaller amount of heat and less damage to surrounding glandular tissue so that in the early postoperative period it was regularly functioning. Also, many more minor ducts could be sealed during such operations, and, therefore, poor wound healing could lead the drainage via the pathway of less resistance: the wound site.

Several methods are mentioned for the treatment of parotid fistulas; however, the use of a pressure dressing is the best choice after parotidectomy. In our patients, as in the literature, 10 - 12 all of the fistulas healed with time and pressure dressing.

Concerning hemostasis, the results were good, but we recorded no significant differences in postoperative bleeding and no significant reduction in early facial nerve weakness. House-Brackmann values were similar in both groups.

Data analysis suggested that the use of the LigaSure system was not a risk factor for the development of facial nerve injuries. In fact, its thermal spread to surrounding tissues is low and heat damage to the nerve is less than or equivalent to that of bipolar electrocautery. In some cases, LigaSure Precise tips are not as thin as mosquito clamp tips and are inadequate for dissection. This new technique is safe, easy to learn, bloodless, and rapid to perform, but it is not followed by a significantly shorter hospital stay, earlier return to work, or reduction in adverse events during or after surgery.

Also, LigaSure has considerably higher costs. This method is comparable with but not superior to conventional methods. The main advantages of LigaSure are the ability to perform a sutureless technique and the decreased operative time. Submitted for Publication : November 16, ; accepted February 3, Our website uses cookies to enhance your experience. None of the bronchi with 6-mm or 7-mm diameter reached the critical pressure without opening. For blood vessels a hydrostatic pressure of mmHg was considered as critical.

For arteries and veins from 1 mm to 7 mm, the average burst pressure was higher than the critical pressure, and all the vascular suture lines remained intact to a pressure higher than mmHg. For sealed lung margins a pneumatic pressure of 60 mmHg was considered critical. Histological examination confirmed the sealing of vessels walls without necrotic coagulation of surrounding tissues.

The depth of thermal injury at the seal line averaged 1. The same findings were observed for bronchi with diameter ranging from 1 to 3 mm. For bronchi with higher sizes the seal obtained by the system was not satisfactory and the lumen often appeared patent at the level of the ligation line. The LigaSure system was subsequently employed in 36 patients undergoing lung surgery.

A total of 23 procedures were performed using LigaSure Standard forceps in 16 patients through thoracotomy 19 wedge resections, 2 segmentectomies, 2 fissure division; Video 1. Twenty patients underwent VATS using the LigaSure Atlas forceps handset, that has both vessel-sealing and tissue-dividing capabilitie 13 wedge resections, 5 bullectomies, 2 dissections of pleural adhesions.

Video 2 shows a thoracoscopic bullectomy; the bulla appears completely adherent to the parietal pleura. In Video 3 the ablation of a nodule located on the diaphragmatic face of the lower lobe is shown.

A number of parameters, including the presence of air leak at the completion of surgery, operating time, duration of thoracic drainage, and length of postoperative stay were recorded.

The disease was benign in 25 patients, malignant in The histology focused on the thermal effects of the sealing system on the lung tissue. In all patients the hemostasis obtained by LigaSure was effective, with minimal perioperative bleeding.