Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Electrocoagulation”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,045 records · Page 58Linked to original sources
PubMed2000

Long-term impact of postoperative radiotherapy in carcinoma of the vulva FIGO I/II.

PURPOSE: Between 1953 and 1978, postoperative radiotherapy was used as an adjuvant therapy for carcinoma of the vulva that had not been treated with radical vulvectomy. We evaluated long-term results and possible prognostic factors. METHODS AND MATERIALS: Ninety-two patients were treated. Surgical procedures were simple vulvectomy, electrocoagulation, or local excision. Radiotherapy doses to the vulva ranged from 0 to 90 Gy. All patients received radiotherapy to the inguinal lymph nodes, ranging from 30 to 60 Gy. Thirty-year retrospective follow-up was done evaluating the records and statistical survival rates. RESULTS: Five-year actuarial survival rates in T1 patients were 71% (77% cause-specific survival rate), for T2 patients 43% (48% cause-specific survival rate). The difference between T1 and T2 patients was significant (p < 0.05). Patients with tumors of the labia minora had a significantly higher survival rate than those with different sites affected. Doses of 45 Gy or more to the vulva were sufficient to increase the 5-year cause-specific survival rate from 55% to 88%. The results in three subgroups were analyzed, group 1 having received electrocoagulation, but no radiotherapy of the vulva; group 2, local excision and doses of 40 Gy to the vulva; group 3, local excision and doses of 60 Gy to the vulva. There was a significant effect on 10-year cause-specific survival rates: 48% in group 1, 11% in group 2, and 88% in group 3. In multivariate analysis, the significant independent factors were T classification, tumor sites and-with only marginal significance-radiation doses to the vulva. CONCLUSIONS: The prognosis in early vulva carcinoma after nonradical surgery primarily depends on T classification and the site of the primary tumor. With univariate analyses, the dose has a significant effect on survival. In multivariate analyses the dose is a marginal independent factor in the whole group of patients. After nonradical surgery of early vulva carcinoma, the vulva should be irradiated resulting in better long-term survival.

Adult↗
PubMed2000

GLOBAL ENDOMETRIAL ABLATION.

Hysteroscopic endometrial ablation was introduced in the 1980's as an alternative to hysterectomy in women who failed medical management. Global endometrial ablation was introduced in the 1990's as an easier, safe, and equally effective alternative to hysteroscopic ablation. Several devices have been introduced, some of which are still undergoing feasibility studies or clinical trials. These devices include: three hot water intrauterine balloons, two intrauterine free saline solutions, a multielectrode electrocoagulating balloon, a 3-D bipolar electrocoagulation probe, a microwave, a diode fibre laser, and at least three cryoprobes. These devices require less operator skill and no irrigant or distending solutions. All require either heat or cold to destroy the endometrium. Although all devices are promising and have produced impressive preliminary results, the long-term efficacy, complication rates, and cost effectiveness have not been established. This review describes all devices as they appeared chronologically and presents only peer-reviewed data.

Journal Article↗
PubMed1994

Laparoscopic removal of gonads containing on occult seminoma in a woman with complete androgen resistance.

A 20-year-old woman with complete androgen resistance (AR; 46,XY), underwent prophylactic laparoscopic gonadectomy because of the known increased risk of gonadal malignancy. The procedure was performed with electrocoagulation using a four-puncture technique. Pelvic and abdominal inspection revealed no gonadal or metastatic tumor. The testes and attached structures were retracted medially, and the peritoneum and gonadal vessels were incised after electrocoagulation, thereby removing the gonads from the sidewalls. The gonads were individually placed into a specimen retrieval bag and removed through the suprapubic cannula site. Pathologic examination revealed an occult 8-mm seminoma in the let gonad, as well as bilateral Sertoli cell hamartomas, fallopian tube remnants, and smooth muscle tissue (mullerian remnants) adjacent to the gonads. Postoperatively, tumor markers were normal, and abdominal and pelvic computerized tomographic scans and chest radiographs were negative for possible metastatic disease. This case confirms that laparoscopic removal of testes in women with AR is effective, safe, and quick. Because of normal-appearing gonad may contain an occult tumor, we recommend using a retrieval bag, which may prevent dissemination of potentially malignant cells that may occur with unprotected morcellation.

Adult↗
PubMed2003

[Preliminary results for superficial parotidectomy using the ultrasonically activated scalpel (Ultracision Harmonic Scalpel)].

BACKGROUND: The high density of blood vessels in the parotid gland, the direct vicinity to the facial nerve and the narrow surgical situs require efficient intra- and postoperative hemostasis. The ultrasonic scalpel (US) accomplishes both tissue dissection and vessel coagulation simultaneously by an ultrasonically activated shear movement of 55 500 Hz. The combination of hemostasis and tissue dissection particularly qualifies US for use in surgery of the parotid gland. Until now, there have been no published studies about application of US in surgery of the parotid gland. METHOD: 20 patients with benign parotid tumors treated with a conventional technique of superficial parotidectomy and 20 patients with a superficial parotidectomy using the ultrasonically activated scalpel were examined in regard to intra- and postoperative hemostasis, wound healing and postoperative pain. Also, the quality of the histopathological specimen obtained by US was evaluated. RESULTS: In 85 % (17/20) of superficial parotidectomy efficient intraoperative hemostasis did not require electrocoagulation. In 15 % (3/20) of parotid tumors additional bipolar electrocoagulation were required because of venous bleeding from vessels exceeding 2.0 mm in diameter. Postoperative bleeding did not occur at all. Wound healing was uneventful in all cases. Surgery-related postoperative pain was not intensified. Time of operation was shortened. Histopathological evaluation, especially in the margin area, was not impaired. CONCLUSION: The US offers tissue dissection with effective intra- and postoperative hemostasis. The combination of simultaneous tissue dissection and hemostasis enables a good overall view and control of the surgical site. In addition, based on the mechanical function the US has only a minimal thermal effect on neighboring tissues and enables controlled tumor resection without damaging the facial nerve.

Adult↗
PubMed1998

A guinea pig model for Q fever endocarditis.

A new model of experimental endocarditis, using electrocoagulation of native aortic valves, was used for the study of Q fever endocarditis. In the 20 guinea pigs electrocoagulated and inoculated with Coxiella burnetii Nine Mile phase I strain, 10 presented with infective endocarditis. Of these, 7 died spontaneously. All guinea pigs with endocarditis presented with blood cultures positive for C. burnetii, and C. burnetii antigen was found in their cardiac valves. Positive blood cultures or valvular immunopositive cells were not identified in either nonelectrocoagulated or noninoculated controls. This experimental model demonstrates that Q fever in an animal with previously damaged valves results in endocarditis. It could provide a new tool for the investigation of pathophysiology and antibiotic therapy for Q fever endocarditis.

Animals↗
PubMed1989

Modification of a model for cerebral ischemia in the cat: a new method to occlude the middle cerebral artery.

A modified method of occluding the middle cerebral artery (MCA) by inserting a tiny copper wire into the lumen of the vessel to make a model for cerebral ischemia in the cat is described. Of 22 rats, 4 were controls and the remaining 18 were divided into two groups. Bipolar electrocoagulation was used in 9 cats and copper wire insertion was used in the other 9 to occlude the MCA through a transorbital approach. Two cats died after surgery and were excluded from this study. Of the 16 cats in two experimental groups, 13 of 14 showed hemiplegia and the other 2 were killed under anesthesia. Typical ischemic changes can be seen in the territory of the occluded MCA. Increased water content and decreased amplitude of somatosensory evoked potentials can be found in the ischemic hemisphere. Histochemical fluorescence study demonstrated that the sympathetic nerve fibers normally existing on the MCA can be completely destroyed by electrocoagulation but may remain intact with the copper wire method. This new method may have less influence on the vascular regulative function of the autonomic nervous system and be more similar to the pathological changes of cerebral infarction in man. We think our method can be useful for further research in cerebral ischemic disease and the regulative effects of the nervous system on brain vessels.

Animals↗
PubMed2003

Restoration of functional motor units in a rat model of sphincter injury by muscle precursor cell autografts.

BACKGROUND: Urinary incontinence is a debilitating condition that affects primarily elderly individuals. One major mechanism results from chronic denervation of the striated urethral sphincter with associated fibrosis. The authors investigated the fate of muscle precursor cells (MPC) injected into a model of striated urethral sphincter injury that reproduces the histopathologic changes of sphincter insufficiency. METHODS: The striated urethral sphincter of older male rats was damaged by electrocoagulation. MPC were isolated from limb myofiber explants, infected with an adenovirus carrying the transgene encoding beta-galactosidase, and injected into the sphincter of the same animal 37 days after injury. Animals were killed 5 and 30 days after injection for assessment of sphincter function and the formation of motor units. RESULTS: Electrocoagulation resulted in an irreversible destruction of both sphincteric myofibers and nerve endings, with a functional incapacity of the damaged sphincter to sustain an increase in bladder pressure; atrophy and fibrosis developed after 1 month. Injection of MPC resulted in the formation of beta-galactosidase-expressing myotubes in the sphincter that persisted beyond 30 days. The regenerated myotubes carried acetylcholine receptors associated with a nerve ending and were thus considered to form anatomic motor units. Urodynamic studies confirmed the restoration of 41% of sphincter function 1 month after MPC injection. CONCLUSIONS: The authors showed that MPC isolated from limb muscles of an older animal can recapitulate a myogenic program when injected into an irreversibly injured sphincter. The maturation of MPC activates nerve regeneration and restores functional motor units.

Animals↗
PubMed1980

Successful methotrexate therapy in oral florid papillomatosis.

Oral florid papillomatosis is a rare syndrome, which was first described under this name by Rock & Fisher in 1960. The same syndrome had been previously described as papillomatosis mucosae oris carcinoides by Scheicher-Gottron (1958). It is a benign condition, capable of malignant degeneration. Surgical excision and electrocoagulation are the most widely used therapeutic methods, despite the fact that relapse of symptoms after treatment by these methods is common. The literature comprises a few reports on favourable therapeutic effects obtained with small doses of methotrexate. This paper describes a patient with multifocal, very extensive form of oral florid papillomatosis, in whom both surgical excision and electrocoagulation were regarded as inadequate in view of the extensiveness of the lesion. Chemotherapy with methotrexate proved to be effective and resulted in complete remission. No relapse has occurred during a follow-up period of over 2 years. The value of chemotherapy with methotrexate in the treatment of an extensive form of oral florid papillomatosis is emphasized.

Aged↗
PubMed1990

The Dieulafoy gastric erosion. An infrequently recognized cause of upper gastrointestinal hemorrhage in the elderly.

Definitive treatment of the Dieulafoy erosion--once recognized--has generally been surgery. Numerous surgical approaches have been suggested, including: simple oversewing of the lesion, wedge restriction, and gastrectomy with and without vagotomy and pyloroplasty. Attempts at endoscopic electrocoagulation and angiographic embolization have generally been disappointing; however, Pointer et al have recently reported satisfactory control of hemorrhage from Dieulafoy lesions with bipolar electrocoagulation and endoscopic injection sclerotherapy, either independently or in combination. These case reports describe two elderly patients with massive upper gastrointestinal tract bleeding from Dieulafoy's gastric erosion; it is hoped the geriatrician will be alerted to an often unrecognized source of hemorrhage.

Aged↗
PubMed1998

Clinical and economic outcomes of individuals with severe peptic ulcer hemorrhage and nonbleeding visible vessel: an analysis of two prospective clinical trials.

OBJECTIVE: We report the clinical outcomes and direct medical costs of 155 patients with severe peptic ulcer hemorrhage and a nonbleeding visible vessel at emergency endoscopy treated with endoscopic hemostasis or medical-surgical therapy. METHODS: In two consecutive, prospective, randomized, controlled trials, patients were randomly assigned to endoscopic hemostasis (heater probe, bipolar electrocoagulation, or injection sclerosis) or medical-surgical treatment. Study endpoints included the incidence of severe ulcer rebleeding and emergency surgery, length of hospital stay, blood transfusion requirements, mortality rate, and direct costs of utilized health care. Direct medical costs were estimated using combined fixed and variable institutional costs for consumed resources and Medicare reimbursement rates. RESULTS: Compared with medical-surgical treatment, endoscopically treated patients had significantly lower rates of severe ulcer rebleeding (p = 0.004), emergency surgery (p = 0.002 and p = 0.019, 0.024), and blood transfusions (p = 0.025). Observed inter-trial differences in ulcer rebleeding rates may be partially explained in a multivariate model by covariates of comorbid disease and inpatient ulcer bleeding. In both trials, length of hospital stay, mortality rates, and treatment-related complications were similar. Estimated median direct costs per patient differed: The first trial had lower costs with endoscopic hemostasis ($4254, vs $4620 for electrocoagulation and $5909 for medical-surgical treatment), yet the second trial yielded lower costs with medical-surgical treatment ($3169, vs $3477 for injection sclerosis and $4098 for heater probe). CONCLUSIONS: Compared with medical-surgical therapy, endoscopic hemostasis for severe ulcer hemorrhage and a nonbleeding visible vessel yielded significantly better patient outcomes and was safe. This procedure may or may not yield lower direct medical costs and cost savings.

Blood Transfusion↗
PubMed1984

The importance of the peripeduncular nucleus in the neuroendocrine control of sexual behavior and milk ejection in the rat.

Electrocoagulations situated in the lateral midbrain tegmentum cause severe deficits in sexual behavior and lactational performance of rats. In this study we determined the extent to which these effects could be reproduced by axon-sparing lesions using the excitotoxin, ibotenic acid; in another group of rats, 6-OHDA was infused in the same area to degenerate the mesencephalic catecholamine neuronal elements affected by the electrocoagulations. It was found that ibotenic acid, but not 6-OHDA, reproduced most of the effects produced by electrolytic lesions. Thus, female rats bearing ibotenic acid lesions showed little sexual receptivity and proceptivity in response to estrogen and progestin treatment, and the milk ejection reflex appeared nonfunctional following the lesion. Ibotenic acid-infused male rats failed to ejaculate on most postoperative observations, though they continued to mount he estrous female. Examination of the lesions with immunohistochemical visualization of tyrosine-hydroxylase- and substance P-positive neurons, and thionine staining, revealed that the neurotoxins exhibited the intended selectivity, though the ibotenic acid lesions were associated with loss of substance P-immunoreactive nerve terminals in the substantia nigra and the peripeduncular region. It is suggested that the peripeduncular nucleus plays an important role in the neuroendocrine control of male and female copulatory behavior, as well as in the regulation of the milk ejection reflex.

Animals↗
PubMed2006

Fibrin sealant reduces pain after tonsillectomy: prospective randomized study.

OBJECTIVES: Postsurgical pain in adults following tonsillectomy with fibrin sealant or electrocoagulation was assessed by surface electromyography (sEMG), a dysphagia severity rating scale (DSRS), and a visual analog scale (VAS) pain METHODS: For group 1 (n = 40), hemostasis was achieved by fibrin sealant spraying to the tonsillar fossae. For group 2 (n = 40), hemostasis was achieved by bipolar or needle point electrocautery. The timing of single swallowing and continuous drinking and the mean electrical activity of the masseter, infrahyoid, and submental-submandibular muscles were compared with a normative database during 30 days and with DSRS and VAS scores. RESULTS: Electrical activity of the masseter and infrahyoid muscles was significantly higher in both groups in comparison with the normative database (p < .05 to p < .005), whereas timing was less affected. The combined sEMG, DSRS, and VAS assessment showed that tonsillectomy ended with sealant causes less pain than electrocoagulation (p < .05). The DSRS score data were in strong positive correlation with the sEMG records, whereas the VAS pain score was less informative. CONCLUSIONS: The combined sEMG and pain score data indicate that the electrocautery hemostatic technique is more painful and traumatic than the sealant technique. Surface electromyography of swallowing is a simple, reliable evaluation method for postsurgical odynophagia complaints and might be used as an objective tool for pain assessment.

Adult↗
PubMed1994

Effect of cerebral arterial occlusion on cerebral perivascular innervation: a histochemical and immunohistochemical study in the rat.

The effect of acute cerebral occlusion on the distribution of cerebral perivascular nerves containing catecholamine, neuropeptide Y, and vasoactive intestinal peptide was studied in the three commonly used rat models of cerebral ischemia: Unilateral permanent middle cerebral artery (MCA) occlusion induced with an intraluminal thread technique; unilateral MCA occlusion produced by extraluminal electrocoagulation of the MCA; and transient arterial occlusion of the whole brain induced extracranially by the four-vessel clasp occlusion method for 30 minutes. Animals were sacrificed 3 days after occlusion and the distribution of the perivascular nerves of the MCA studied. Intraluminally occluded MCAs showed a similar distribution of perivascular nerves to those of contralateral and sham-operated MCAs. Extraluminally occluded MCAs demonstrated a marked decrease in perivascular nerves containing catecholamine and peptides while the contralateral MCAs showed normal distribution of the nerves. Extracranial occlusion caused no discernible change in the distribution of perivascular nerves in occluded and sham-operated animals. This study indicates that the different methods of cerebral arterial occlusion have variable effects on the perivascular innervation. Arterial occlusion induced by intraluminal or transient extracranial procedures does not impair cerebral perivascular innervation at least up to 3 days post-occlusion. In contrast, cerebral arterial occlusion by extraluminal electrocoagulation diminishes the perivascular nerves around the occluded cerebral artery.

Animals↗
PubMed1986

Echocardiographic detection and treatment of intraoperative air embolism.

A real-time two-dimensional echocardiogram was used to detect the presence of an air embolism in patients undergoing neurosurgical procedures in the sitting position. The technique could with good sensitivity detect the appearance of a single air bubble intraoperatively, thus allowing early intervention to prevent development of further air emboli. Two types of air embolism could be differentiated; the single-bubble type and the "stormy-bubble" type. The single-bubble type was observed during skin and muscle incisions, craniotomy, and brain lesion excision. Further embolism development was prevented by electrocoagulation and application of bone wax. The stormy-bubble type occurred during dura and muscle incisions and was prevented by electrocoagulation, reflection of the dura, or suturing the affected muscle. The routine use of a Swan-Ganz catheter for removal of air embolism by suction proved effective for the treatment of the stormy-bubble type of air embolism. Masking the operative field with saline-soaked cotton strips was of moderate benefit in the stabilization of the single-bubble type of air influx, but proved to be of little value in controlling the entrance of the stormy-bubble type.

Echocardiography↗
PubMed2005

A pragmatic randomised controlled trial of the cost-effectiveness of palliative therapies for patients with inoperable oesophageal cancer.

OBJECTIVES: To compare whether treatment with self-expanding metal stents (SEMS) is more cost-effective than treatment with conventional modalities in patients with inoperable oesophageal cancer. Quality of life effects were also considered. DESIGN: A multicentre pragmatic, randomised controlled trial with health economic analysis. SETTING: Seven NHS hospitals selected to represent a cross-section of UK hospitals in terms of facilities and staffing. PARTICIPANTS: All patients attending the centres with oesophageal cancer deemed unsuitable for surgery were assessed for inclusion in the main trial; 217 patients were randomised. A health state utilities substudy was also performed in 71 patients who had previously received curative surgery for oesophageal cancer. INTERVENTIONS: Eligible patients were randomised to one of four treatment groups within two study arms. Assessments were performed at enrolment, 1 week following treatment and thereafter at 6-weekly intervals until death, with prospective data collection on complications and survival. Structured interviews to elicit patient preferences to health states and treatments were performed in a substudy. MAIN OUTCOME MEASURES: Dysphagia grade and quality of life were examined at 6 weeks. Survival, resources consumed from randomisation to death and quality-adjusted life-years were also considered. RESULTS: There was no difference in cost or effectiveness between SEMS and non-SEMS therapies, and 18-mm SEMS had equal effectiveness to, but less associated pain than, 24-mm SEMS. Rigid intubation was associated with a worse quality of swallowing and increased late morbidity. Bipolar electrocoagulation and ethanol tumour necrosis were poor in primary palliation. A survival advantage was found for non-stent therapies, but there was a significant delay to treatment. The length of stay accounts for the majority of the cost to the NHS. Patients were found to have distinct individual treatment preferences. CONCLUSIONS: It was suggested that rigid tubes and 24-mm SEMS should no longer be recommended and bipolar electrocoagulation and ethanol tumour necrosis should not be used for primary palliation. The choice in palliation would between non-stent and 18-mm SEMS treatments, with non-stent therapies being made more available and accessible to reduce delay. A multidisciplinary team approach to palliation is also suggested. A randomised controlled clinical trial of 18-mm SEMS versus non-stent therapies with survival and quality of life end-points would be helpful, as would an audit of palliative patient admissions to determine the reasons and need for inpatient hospital care, with a view to implementing cycle-associated change to reduce inpatient stay. A study of delays in palliative radiotherapy treatment is also suggested, with a view to implementing cycle-associated change to reduce waiting time.

Aged↗
PubMed2000

[Laparoscopy and laparotomy in the operative treatment of ovarian cysts].

OBJECTIVES: The purpose of our study was to compare operative procedures, histologic types of tumours, and intra- and postoperative complications of patients operated for benign ovarian cysts by laparotomy or laparoscopy. MATERIALS AND METHODS: 257 patients with different types of ovarian cysts underwent operations by laparoscopy (51 cases) or laparotomy (206 cases). Careful selection for operative treatment was made on the basis of clinical findings, ultrasound scans (using colour Doppler), patient's age and history. Operative laparoscopies were performed in patients with "unsuspected" ovarian cysts with diameter < or = 8 cm. During every operation, a histologic examination of tumour was performed. RESULTS: In 42 patients the cysts were found in both ovaries. Remaining 215 women had unilateral ovarian tumours. Adnexectomy was carried out in 142 cases, cystectomy in 131, ovariectomy in 18, and aspiration and electrocoagulation of ovarian cysts in 8 cases. The most common laparoscopic procedures were cystectomy (41) and aspiration and electrocoagulation of ovarian cysts (8); while by laparotomy: adnexectomy (142) and cystectomy (131); p < 0.0001. The histopathological assessment showed as follows: serous cysts in 98 cases, dermoid cysts in 75, endometrial cysts in 63, mucous cyst in 23, and others (mainly haemorrhagic, functional cysts and fibrothecomas) in 40 cases. The incidence of operative complications (3/257--all due to insufficient hemostasis) and postoperative complications (infection--7/257, anaemia--4/257, peritonitis--1/257) was rather low and similar in patients operated by laparoscopy and laparotomy. Patients were generally discharged from the hospital on the fourth (median) postoperative day after laparoscopies and the seventh (median) day after laparotomies (p < 0.0005). CONCLUSIONS: Operative treatment of ovarian benign cysts is connected with a very low risk for intra- and postoperative complications. The operative laparoscopy brings better cosmetic effects and seems to be safe and effective method of treatment of ovarian benign cysts.

Adolescent↗
PubMed2003

[Bladder hemangioma after radiotherapy].

OBJECTIVES: Bladder hemangiomas are exceptional benign tumours representing 0.6% bladder tumours. Most times they present as solitary, unique lesions; radiological signs are very similar to urothelial neoplasias making differential diagnosis or at least diagnostic suspicions very difficult due to its low incidence. We perform a bibliographic review and comment on its clinical and pathological characteristics, as well as on diagnostic methods and latest modifications in therapy. METHODS: We present a case of bladder haemangioma secondary to pelvic radiotherapy, being this presentation unique among approximately 100 cases described in the literature. RESULTS: From cystoscopy we suspected the lesion could be an endothelial neoplasia based on its vascular appearance. We performed transurethral resection and electrocoagulation of the lesion because it was small and unique. Pathology report confirmed it was a bladder hemangioma secondary to radiotherapy, being this an exceptional presentation. There has been no relapse up to date. CONCLUSION: We think that resection and electrocoagulation of unique, solitary bladder hemangiomas is a therapeutic option to be taken into consideration in the management of this kind of benign tumours.

Adenocarcinoma↗
PubMed2003

Ligasure versus sutures in bladder replacement with Montie ileal neobladder after radical cystectomy.

OBJECTIVES: Electrocoagulation became an indispensable tool for surgeons. Ligasure is a computer-based, temperature-controlled bipolar electrocoagulation system designed as an alternative to suture ligatures, staplers, hemoclips and ultrasonic coagulators for legating vessels and tissue bundles. Our aim was to analyse the procedure time and intraoperative blood loss of the ileal neobladder in a series of 30 highly selected patients. PATIENTS AND METHODS: From March 1999 to May 2002, 30 patients (all men), 47 to 74 years old (mean age 57) with good performance status (American Society of Anesthesiology score 1 and 2) underwent radical cystectomy for bladder cancer and Montie ileal neobladder reconstruction, using standard surgical technique, with the exception of 15 patients that the Ligasure device was used for haemostasis. RESULTS: Procedure time was significantly less in the Ligasure arm 170 minutes (range: 150 min - 200 min ) versus 220 minutes (range: 160 min - 250 min) in the suture arm (p < 0.001). Blood loss was significantly less in the Ligasure arm an average 849 cc (range: 820 cc - 900 cc) versus 968 cc (range: 1110 cc - 897 cc) in the suture arm p < 0.02). There was no post-operative hemorrhage or return to the operating room in either arm. Two patients, one in each arm, received two units of blood for a slowly decreasing hematocrit on postoperative day 3. There was no evidence of collateral tissue injure and no injuries to the urinary or intestinal tract in either arm. CONCLUSIONS: Ligasure is a safe and effective alternative to sutures in cystectomy and bladder replacement, resulting in decreased blood loss and significant time saving.

Aged↗