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Comparison of perioperative surgical outcomes between a bipolar device and an ultrasonic device during laparoscopic gastrectomy for gastric cancer

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Abstract

Background

The use of energy devices during laparoscopic gastrectomy for gastric cancer has increased as the frequency of laparoscopic surgery has increased. Our aim was to compare the perioperative surgical outcomes between using a bipolar device and an ultrasonic device during laparoscopic gastrectomy.

Methods

Retrospective review of a prospectively maintained database identified 186 patients who underwent laparoscopic gastrectomy performed by a single surgeon between November 2010 and August 2013. A bipolar device was used for 116 patients, and an ultrasonic device was used for 70 patients. Patient characteristics and perioperative surgical outcomes were compared between groups.

Results

Clinicopathologic characteristics were similar for both groups. The bipolar group had a significantly shorter operation time (154.9 vs. 167.8 min, p = 0.028) and higher rate of D2 lymph node dissection (29.3 vs. 15.7 %, p = 0.012). The bipolar device group experienced significantly less pain at 12 h [visual analog scale (VAS) pain score: 3.9 vs. 4.7, p = 0.027) and 18 h (VAS pain score: 3.5 vs. 4.1, p = 0.036) postoperatively. The bipolar group had earlier abdominal drain removal (p = 0.001) and a shorter hospital stay (p = 0.024). No significant differences in laboratory value changes, morbidity, or mortality were observed between the groups.

Conclusion

Compared with the ultrasonic device, the bipolar device provided advantages in operation time, degree of postoperative pain, time of drain removal, and length of hospital stay. The bipolar device may be a useful and efficient energy device for laparoscopic gastrectomy. However, larger studies to confirm the safety of bipolar device during laparoscopic gastrectomy are warranted.

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Acknowledgments

This research was supported by Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Science, ICT & Future Planning (2013R1A1A1007706).

Disclosure

Kim You-Na, Yoo YC, Guner A, Cho I, Kwon IG, Kim Youn Nam, and Kim HI have no conflicts of interest or financial ties to disclose.

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Authors and Affiliations

  1. Department of Surgery, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, Korea

    You-Na Kim, Ali Guner, In Cho, In Gyu Kwon & Hyoung-Il Kim

  2. Department of Anesthesiology and Pain Medicine, Yonsei University College of Medicine, Seoul, Korea

    Young-Chul Yoo

  3. Department of General Surgery, Trabzon Kanuni Training and Research Hospital, Trabzon, Turkey

    Ali Guner

  4. Department of Surgery, International St. Mary’s Hospital, Inchon, Korea

    In Cho

  5. Department of Surgery, Graduate School, Yonsei University College of Medicine, Seoul, South Korea

    In Cho

  6. Department of Surgery, Keimyung University School of Medicine, Daegu, Korea

    In Gyu Kwon

  7. Department of Biostatistics, Yonsei University College of Medicine, Seoul, Korea

    Youn Nam Kim

  8. Gastric Cancer Clinic, Severance Hospital, Yonsei University Health System, Seoul, Korea

    Hyoung-Il Kim

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  1. You-Na Kim
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  2. Young-Chul Yoo
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Correspondence to Hyoung-Il Kim.

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Kim, YN., Yoo, YC., Guner, A. et al. Comparison of perioperative surgical outcomes between a bipolar device and an ultrasonic device during laparoscopic gastrectomy for gastric cancer. Surg Endosc 29, 589–595 (2015). https://doi.org/10.1007/s00464-014-3702-8

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  • DOI: https://doi.org/10.1007/s00464-014-3702-8

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