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Comparative Study between Harmonic Scalpel and LigaSure Vessel Sealing System: In Open and Laparoscopic Surgery

AIMS AND OBJECTIVES Cakan A et al studied the safety and efficacy of the
LVSS and HS in sutureless nonanatomical lung resections
The present study is designed to compare between HS and
LVSS in open and laparoscopic surgery. on 20 adult rabbit lungs in which 1 × 1 cm wedge resections
were performed under one-lung ventilation with both
MATERIALS AND METHODS LVSS and HS and compared the air tightness and tissue
damage caused by them. They found no statistical
The literature regarding this review article was searched significant difference when the air tightness for both
online on various websites, like Google, PubMed, World devices was compared after resection (p = 0.37) and
Journal of Gastrointestinal Surgeons, YouTube. Search concluded that their study LVSS and HS can both be used
words used were LigaSure vs HS, LVSS role of vessel sealer for peripheral lung resections without any need of further
and HS in laparoscopic surgery. intervention for securing the air tightness, but LVSS was
found safer by means of tissue damage when compared
DISCUSSION
with HS in this experimental study. 3
Kwok SY et al in their double-blinded study did a Zarebczan B et al did a retrospective study to compare
randomized trial comparing LigaSure and HS hemorrhoi- the LigaSure and HS in thyroid surgery. Their study included
dectomy. Forty-nine patients with grades 3 and 4 a total of 231 patients of whom 123 underwent total
hemorrhoids admitted for hemorrhoidectomy were selected thyroidectomy and 108 underwent lobectomy. They found
and randomized into two groups: (1) LigaSure hemorrhoi- that there was a significant decrease in the operative time
dectomy or (2) HS hemorrhoidectomy. The primary for both thyroidectomies and lobectomies when the HS was
outcomes measured were the analgesic requirement and the utilized. But in regard to complications, there was no
postoperative pain score (assessed by an independent statistically significant difference in the number of transient
assessor). Secondary outcome criteria included the operating and permanent recurrent laryngeal nerve injuries, percentage
time, blood loss, hospital stay, patient satisfaction score, of patients developing hypocalcemia or rate of hematoma
and early and late complications and they concluded that development. And, concluded that there was no difference
LigaSure hemorrhoidectomy reduces the postoperative pain in the rate of complications between the two devices.
and operating time compared to the HS hemorrhoidectomy. However, the use of the HS significantly decreased operative
And, it is a safe, effective procedure for treating grades 3 time for both thyroidectomies and thyroid lobectomies
and 4 hemorrhoids. 1 compared with the LigaSure device. 4
Smith et al in a prospective comparison of four An inference can also be made from a video available
laparoscopic vessel ligation devices found that the LigaSure online on the site www.youtube.com, which shows the
had the best overall performance with the highest burst infrared camera recording of the probes of LVSS and HS
pressure, low thermal spread, fast sealing time, and low which compares the lateral thermal spread of both the
smoke production. By contrast, the HS has the lowest instruments, which is more in LVSS as compared to HS
thermal spread and smoke production but was slow and had (Fig. 3). It might be also due to a slightly bigger probe tip
the lowest mean burst pressure. 2 of LVSS as compared to smaller probe tip of HS shear. 5

Fig. 1: LigaSure vessel sealing system Fig. 2: Harmonic scalpel
World Journal of Laparoscopic Surgery, May-August 2013;6(2):74-76 75