Sutureless and stapleless laparoscopic splenectomy using radiofrequency: LigaSure device

Area of Science:

• Minimally Invasive Surgery
• Surgical Technology
• Vascular Sealing

Background:

• Bleeding is a primary complication during laparoscopic splenectomy (LS).
• Vascular control is critical for safe conversion during LS.
• The LigaSure vessel sealing system offers a potential solution for safe vascular control.

Purpose of the Study:

• To evaluate the safety and efficacy of the LigaSure vessel sealing system.
• To assess the benefits of combining LigaSure with a lateral approach for LS.
• To reduce complications and conversions during LS.

Main Methods:

• A consecutive series of 63 laparoscopic splenectomies (LS) were performed over 3 years.
• The LigaSure vessel sealing system was utilized for all cases.
• A right semilateral position technique was employed with spleen dissection and vessel sealing.

Main Results:

• 58 out of 63 LS were completed successfully, with five conversions due to bleeding or difficult dissection.
• Blood loss was minimal (<100 ml) in most patients, with no transfusions required.
• Postoperative complications included portal thrombosis, hemoperitoneum, wound infection, and pleural effusion.

Conclusions:

• The combination of LigaSure and a semilateral approach enhances safety and efficiency in LS.
• This technique leads to significant reductions in intraoperative blood loss.
• LigaSure facilitates quicker and safer vascular control during laparoscopic splenectomy.