ABSTRACT

Laparoscopic surgery is increasingly being performed for benign and malignant colorectal disease. This study examines the short-term results and efficency of LigaSure vessel sealing system in a series of laparoscopic colorectal procedures including also obese patients.

Data were collected for 26 patients who underwent laparoscopic colorectal procedures with LigaSure device. Analyzed variables included patient characteristics (age, sex, body mass index), operative data (type of laparoscopic procedure, operative time, intraoperative blood loss, conversion to open surgery, complications), difference between preoperative and postoperative hemoglobin levels, final pathological result, surgical margins, lymph node harvest and length of hospital stay.

Laparoscopic colorectal procedures with LigaSure were right hemicolectomy for 10 patients, left hemicolectomy for 14 patients and abdominoperineal resection for 2 patients. 15 (57,6 %) were female and 11 (42,3 %) were male. Mean age was 65,08 ± 10,9 years (range 35-82) years and mean body mass index was 30.01 ± 5,7 kg/m² (range 23,3-45,7). Overall mean operative time was 118,6 ± 28,7 min (range 90-200), mean intraoperative blood loss was 134,2 ± 28,6 ml (range 90-200) and the mean difference between preoperative and postoperative hemoglobin levels was 0,92 ± 0,96 g/dl (range 0-3,5). Mean hospital stay was 4,04 ± 1,07 days (range 3-7) and the median lymph node harvest in malignancies was 21,4 ± 5,7 (range 7-30) nodes. Complications were encountered in 3 patients (pulmonary infection, prolonged ileus and subcutaneous haematoma). Conversion to open surgery was not needed in any of the patients.

Laparoscopic surgery can be performed safely with Ligasure vessel sealing system in benign and malign colorectal diseases and obesity is not an extra risk factor for bleeding in this procedure, furthermore laparoscopic approaches in colorectal diseases have such advantages as low complication rate, low rates of unintended laparotomy and short hospital stay.