Use of a computer-controlled bipolar diathermy system in radical prostatectomies and other open urological surgery.

TLDR: Ligasure® is a computer‐controlled bipolar diathermy system, designed to optimally seal vessels ≤ 7 mm in diameter, and its application to open urological surgery was evaluated.

Abstract: Background: Ligasure® is a computer-controlled bipolar diathermy system, designed to optimally seal vessels ≤ 7 mm in diameter. The aim of the present study was to evaluate its application to open urological surgery. Methods: The Ligasure® device was used in 32 consecutive open surgical cases, including 25 radical prostatectomies, five radical nephrectomies, one partial nephrectomy and one nephro-ureterectomy. All procedures were performed using standard surgical techniques, with the exception that the Ligasure® device was used for haemostasis. This included pelvic lymphatics and prostatic, adrenal, gonadal and aberrant obturator vessels, as well as vessels associated with the ureter, vasa, seminal vesicles, peri-renal fat, peritoneum and peri-adrenal tissues. Vessels > 7 mm in diameter, such as the renal artery, were ligated. In no patients were haemostatic clips used. Results: In all procedures, vessels and other structures < 7 mm were successfully sealed using the Ligasure® device. For some structures, such as the prostatic pedicles and the seminal vesicles, the Ligasure® device was much easier to apply than haemostatic clips. Use of the Ligasure® device reduced the operating time (mean: 113 min vs 135.5 min; P < 0.001) and blood loss (mean: 529 mL vs 642 mL; P < 0.02) for radical prostatectomies. No intraoperative or postoperative blood transfusions were required. There were no postoperative haemorrhages, lymph leakage or lymphocoeles. Median inpatient hospital stay was 7 days (range: 6–9 days) and no patients required readmission. Conclusion: The Ligasure® device was safe and easy to use in major urological procedures.