Most recent update: Thursday, February 14, 2019 - 14:58

Bariatric News - Cookies & privacy policy

You are here

LigaSure vs Harmonic for LSG

No differences between Harmonic and LigaSure devices in LSG patients

Regarding the rates of intra-operative and post-operative complications and the number of surgical revisions, there were no significant differences between groups

There are no significant differences between ultrasonic systems such as the Harmonic scalpel and electrothermal bipolar-activated devices such as the LigaSure device in patients undergoing laparoscopic sleeve gastrectomy (LSG), according to researchers from Federico II University, Naples, Italy. They note that the choice of the energy device should be based on the preference of the surgeon and on the hospital cost policy.

The research featured in the paper, ‘Comparison between LigaSure™ and Harmonic® in Laparoscopic Sleeve Gastrectomy: A Single-Center Experience on 422 Patients’, published in the Journal of Obesity, retrospectively compared intraoperative performance, postoperative results and clinical outcomes of LigaSure and Harmonic in 422 patients undergoing LSG. The researchers compared operative time and intra-operative and post-operative (within 30 days from surgery) complications. Intra-operative complications including bleeding from the omentum or from the staple line and use of haemostatic clips and absorbable haemostat, and post-operative complications were recorded as haemorrhages, abscess formation, gastric leaks, fever and mortality. The choice of the device (LigaSure or Harmonic) was based on the availability of the centre, both surgeons have used both devices from the beginning of the learning curve.

Outcomes

Of the 422 patients who had LSG, 108 (25.6%) were men and 314 (74.4%) were women; 225 of them were operated using the LigaSure device and the other 197 were operated using the Harmonic device. There were no differences in terms of age, BMI, comorbidities (diabetes and hypertension), and length of stay between the two cohorts, and there were no differences in the number of cartridges used during surgery.

The operative time at the beginning of the learning curve (first 25 cases operated with LS vs first 25 cases operated with HA) did not significantly differ between groups (159±7 vs 161±9 min, p=0.384). interestingly, there were also no significant differences observed when considering operative time in last 25 cases operated with the devices (LigaSure 48±9 vs 49±6 min Harmonic, p=0.646). Regarding the rates of intra-operative and post-operative complications and the number of surgical revisions, there were no significant differences between groups (Figure 1).

Figure 1: Intraoperative and postoperative complications occurred with Harmonic and LigaSure in the patients’ cohort (within 30 days)

“To the best of our knowledge, this study involves the largest series of patients undergoing LSG in which differences between Harmonic and LigaSure use is analysed, and the results we obtained failed to show a clear advantage in favour of one of the two devices,” the authors noted. “The difference in operative time observed in favour of LigaSure, although not significant, seems to depend principally on surgical dissecting difficulties observed in some patients treated with Harmonic, but these adverse events did not lead to any clinical consequence in the postoperative course.”

However, they do acknowledge that the study is limited by its retrospective design.

“Our findings suggest that Harmonic and LigaSure are both useful in bariatric surgery, and these two advanced power devices are user-friendly and can reduce surgeon work load; from this point of view, the choice of the energy device should be based on the preference of the surgeon and on the hospital cost policy,” the researchers concluded.

To access this paper, please click here

Want more stories like this? Subscribe to Bariatric News!

Bariatric News
Keep up to date! Get the latest news in your inbox. NOTE: Bariatric News WILL NOT pass on your details to 3rd parties. However, you may receive ‘marketing emails’ sent by us on behalf of 3rd parties.