Editorial
Copyright ©2012 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastrointest Surg. Jan 27, 2012; 4(1): 1-8
Published online Jan 27, 2012. doi: 10.4240/wjgs.v4.i1.1
Literature review of the energy sources for performing laparoscopic colorectal surgery
Tsukasa Hotta, Katsunari Takifuji, Shozo Yokoyama, Kenji Matsuda, Takashi Higashiguchi, Toshiji Tominaga, Yoshimasa Oku, Takashi Watanabe, Toru Nasu, Tadamichi Hashimoto, Koichi Tamura, Junji Ieda, Naoyuki Yamamoto, Hiromitsu Iwamoto, Hiroki Yamaue
Tsukasa Hotta, Katsunari Takifuji, Shozo Yokoyama, Kenji Matsuda, Takashi Higashiguchi, Toshiji Tominaga, Yoshimasa Oku, Takashi Watanabe, Toru Nasu, Tadamichi Hashimoto, Koichi Tamura, Junji Ieda, Naoyuki Yamamoto, Hiromitsu Iwamoto, Hiroki Yamaue, Second Department of Surgery, Wakayama Medical University, School of Medicine, Wakayama 641-8510, Japan
Author contributions: Hotta T and Yamaue H concept and designed the study; Hotta T, Takifuji K, Yokoyama S, Matsuda K, Oku Y, Hashimoto T and Yamamoto N collected the data; Hotta T, Higashiguchi T, Tominaga T, Ieda J and Iwamoto H analyzed and explained the data; Hotta T and Tamura K drafted the manuscript; Watanabe T and Nasu T Revised the article critically for important intellectual content; Hotta T made the final approval of the version to be published.
Correspondence to: Tsukasa Hotta, MD, Second Department of Surgery, Wakayama Medical University, School of Medicine, 811-1, Kimiidera, Wakayama 641-8510, Japan. hotta@wakayama-med.ac.jp
Telephone: +81-73-4410613 Fax: +81-73-4466566
Received: December 12, 2010
Revised: October 26, 2011
Accepted: December 8, 2011
Published online: January 27, 2012
Abstract

Laparoscopic surgery for colorectal disease has become widespread as a minimally invasive treatment. This is important because the increasing availability of new devices allows us to perform procedures with a reduced length of surgery and decreased blood loss. We herein report the results of a literature review of energy sources for laparoscopic colorectal surgery, focused especially on 6 studies comparing ultrasonic coagulating shears (UCS) and other instruments. We also describe our laparoscopic dissection techniques using UCS for colorectal cancer. The short-term outcomes of surgeries using UCS and Ligasure for laparoscopic colorectal surgery were superior to conventional electrosurgery. Some authors have reported that the length of surgery or blood loss when Ligasure was used for laparoscopic colorectal surgery is less than when UCS was used. On the other hand, a recent study demonstrated that there were no significant differences between the short-term outcomes of UCS and Ligasure for laparoscopic colorectal surgery. It is therefore suggested that the choice of technique used should be made according to the surgeon’s preference. We also describe our laparoscopic dissection techniques using UCS (Harmonic ACE) for colorectal cancer with regard to the retroperitoneum dissection, dissection technique, dissection technique around the feeding artery, and various other dissection techniques. We therefore review the outcomes of using various energy sources for laparoscopic colorectal surgery and describe our laparoscopic dissection techniques with UCS (Harmonic ACE) for colorectal cancer.

Keywords: Laparoscopic surgery, Ultrasonic coagulating shears, Harmonic Scalpel, Ligasure, Colon and rectum, Dissection technique