Evaluation of the results of Splenic Vessels Ligation by LigasureTM in Laparoscopic Splenectomy in Patients of Surgical Ward in Shariati Hospital during 2007 -2009

Introduction & Splenectomy is among the operations that are performed laparoscopically nowadays. One of the challengaes in this surgery is hilar vessels ligation. It is especially critical about the spleen which is prone to hemorrhage and its resection is based on hilar vessels ligation. Ligasure which ligates the vessels with bipolar electrical activity seems simple, effective and safe. The purpose of the current study was to evaluate the function and safety of ligasure in performing laparoscopic splenectomy and its possible complications. This was a descriptive study to assess safety and weakness of Ligasure in laparoscopic splenectomy. The study carried out on patients with idiopathic thrombocytopenic purpura (ITP) who needed splenectomy in Shariati hospital. During the study period, 35 patients with ITP underwent laparoscopic splenectomy with Ligasure vessel sealing system. We assessed surgery duration, intraoperative and postoperative bleeding, decrease in hemoglobin due to surgery, need to blood transfusion during or after surgery, and need to conversion to open surgery as well as post operative complications and hospital stay. 35 patients were included in this study, with the mean age of 31.5±9.2 years. 25 patients were male and 10 were female. Mean operative time was 132±40 minutes. Intraoperative bleeding volume was 145±103 ml. Decrease of hemoglobin level due to surgery was 1.8±1.1dL. Postoperative hospital stay was 3.8±1.4 days. None of the cases converted to open surgery. Intraoperative or postoperative blood transfusion was required for three patients. The amount of bleeding from abdominal drain was 104±90 cc. According to the result of our study, ligating hilar vessels of spleen with ligasure in patients with ITP is safe in laparoscopic surgery which results in appropriate hemostasis without major bleeding during or after operation. Thus, this method is recommended in the case of laparoscopic splenectomy of patients without splenomegaly, such as idiopathic thrombocytopenic purpura.