A comparative study of laparoscopic extraperitoneal lymphadenectomy [correction of laparoscopy] with the use of ultrasonically activated shears.

Abstract

We evaluated the use of the harmonic scalpel in reducing the occurrence of symptomatic lymphoceles and its related complications in paraaortic laparoscopic lymphadenectomies (PALLs). All PALL that were performed at the Institut Claudius Regaud between January 2003 and June 2007 were included. Since January 2006, the harmonic scalpel has been used systematically for all lymphostasis. Lymphoceles that required treatment were recorded as a complication. Ninety-eight patients were enrolled, 62 PALLs were performed with the standard technique (control group), and 36 PALLs were performed with the harmonic scalpel (study group). There were no differences regarding operating time, blood loss, median nodal yield, and duration of hospital stay. Seven patients of the control group vs none of the study group (P = .03) experienced a symptomatic lymphocele that required medical treatment; 4 patients had radiologic drainage, and 1 patient had surgical drainage. We demonstrate the efficacy of harmonic scalpel in reducing the occurrence of symptomatic lymphoceles in paraaortic extraperitoneal lymphadenectomy.