Efficacy and Safety of Combined Ultrasonic and Bipolar Energy Source in Laparoscopic Surgery.
AIM
Energy devices represent an alternative to clips and staplers for vessel sealing. Outcome data of patients undergoing laparoscopic surgery with use of a novel combined ultrasonic and bipolar energy device (TB, Thunderbeat™) was gathered.


METHODS
Consecutive patients undergoing laparoscopic surgery using TB were prospectively included between November 2011 and January 2016. Large vessels were dissected using the energy device without additional clips or staplers. The type of procedure, operative time, length of stay, complications, blood transfusions, number and type of vessels being dissected, and need for additional clips were noted.


RESULTS
Six hundred eighty-three patients underwent 758 procedures with dissection of 1310 large vessels. No additional hemoclips or vascular staplers were used. There were 0.7 % (5/758) intraoperative and 2.6 % (20/758) postoperative bleeding complications. Eleven bleeding occurred at the stapler line of anastomosis, leaving 1.8 % (14/758) bleeding that were potentially related to inadequate hemostasis. Failure of large vessel dissection occurred in two cases (0.15 %, 2/1310) and device-related complications in 1.1 % (8/758). Two of 42 conversions (5.5 %) were bleeding-related.


CONCLUSION
TB provides a reliable and effective hemostasis. However, ligation failure may occur. As with any kind of electrosurgery, the hot tip of the instruments bears the risk of potentially fatal thermal injuries.
['Steinemann|Daniel C|DC|', 'Lamm|Sebastian H|SH|', 'Zerz|Andreas|A|']
D016063:Blood Loss, Surgical D004210:Dissection D005260:Female D006489:Hemostatic Techniques D006801:Humans D010535:Laparoscopy D008297:Male D008875:Middle Aged D061646:Operative Time D014465:Ultrasonics
Ultrasonic Bipolar Energy source Laparoscopy