Journal of Maxillofacial and Oral Surgery

, Volume 17, Issue 4, pp 495–501 | Cite as

Bipolar Vessel Sealing System Versus Suture Ligation in Selective Neck Dissection

  • Niranjan MishraEmail author
  • Dipti Samal
  • Indu Bhusan Kar
  • Gaurav Sharma
  • Shadab Ali Baig
  • Rosalin Kar
  • Krishna Gopal Birmiwal
  • Gyana Ranjan Sahu
Original Article



To evaluate whether the use of electrothermal bipolar vessel sealing system reduces the blood loss and operating time, with lesser complications as compared to suture ligation in selective neck dissection in patients with oral cancer.

Materials and Methods

The study was conducted in the Department of Oral and Maxillofacial Surgery of our institute from January 2015 to December 2016. The sample consisted of 60 patients, divided into Groups I and II with 30 subjects in each. In Group I electrothermal bipolar vessel sealer and in Group II suture ligation were used. The outcome measures recorded were: blood loss, operating time, quality of surgical field, postoperative pain on days 1, 2, and 3, drainage volume at 24, 48, and 72 h, edema, complications, and duration of hospital stay.


There were 36 males and 24 females with a mean age of 50.76 ± 12.6 years. Blood loss was significantly less for Group I than for Group II (p = 0.001); the operating time was significantly less in Group I than in Group II (p = 0.001); Group I had better quality of surgical field (p = 0.001); less pain on postoperative evening, day 2 and day 3 (p < 0.05); and less drainage volume at 24 and 48 h (p < 0.05). Postoperative edema, complications, need for perioperative blood transfusion, and duration of hospital stay postsurgery were similar in both groups.


The electrothermal bipolar vessel sealer was efficacious in terms of reducing blood loss and operating time while providing a better surgical field and patient compliance without increasing the perioperative morbidity.


Electrothermal bipolar vessel sealer Suture ligation Selective neck dissection 



We would like to show our gratitude toward all the patients who were part of this study for being cooperative and supportive throughout the research. We are highly thankful to Dr. Bana Bihari Mishra, Associate Professor, Department of General Surgery, VIMSAR, Burla, and Dr. Bipin Bihari Pradhan, Professor and Head, Department of Physiology, SCBMCH, Cuttack for their immense help and valuable guidance during the study. We are very grateful to Dr. Debashish Pati and Dr. Brundabati Meher for helping and preparing the final manuscript. Finally, we would like to thank all those who directly and indirectly became part of this study.

Compliance with Ethical Standards

Conflict of interest



  1. 1.
    Manouras A, Markogiannakis HE, Kekis PB, Lagoudianakis EE, Fleming B (2008) Novel hemostatic devices in thyroid surgery: electrothermal bipolar vessel sealing system and harmonic scalpel. Expert Rev Med Devices 5(4):447–466PubMedCrossRefGoogle Scholar
  2. 2.
    Landman J, Kerbl K, Rehman J et al (2003) Evaluation of a vessel sealing system, bipolar electrosurgery, harmonic scalpel, titanium clips, endoscopic gastrointestinal anastomosis vascular staples and sutures for arterial and venous ligation in a porcine mode. J Urol 169:697–700PubMedCrossRefGoogle Scholar
  3. 3.
    Heniford BT, Matthews BD, Sing RF, Backus C, Pratt B, Greene FL (2001) Initial results with an electrothermal bipolar vessel sealer. Surg Endosc 15(8):799–801PubMedCrossRefGoogle Scholar
  4. 4.
    Harold KL, Pollinger H, Matthews BD et al (2003) Comparison of ultrasonic energy, bipolar thermal energy, and vascular clips for the hemostasis of small-, medium-, and large-sized arteries. Surg Endosc 17:1228–1230PubMedCrossRefGoogle Scholar
  5. 5.
    Kennedy JS, Stranahan PL, Taylor KD, Chandler JG (1998) High-burst-strength feedback controlled bipolar vessel sealing. Surg Endosc 12:876–878PubMedCrossRefGoogle Scholar
  6. 6.
    Campbell PA, Cresswell AB, Frank TG, Cuschieri A (2003) Real-time thermography during energized vessel sealing and dissection. Surg Endosc. PubMedCrossRefGoogle Scholar
  7. 7.
    Janssen PF, Brölmann HAM, Huirne JAF (2012) Effectiveness of electrothermal bipolar vessel-sealing devices versus other electrothermal and ultrasonic devices for abdominal surgical hemostasis: a systematic review. Surg Endosc. PubMedCrossRefGoogle Scholar
  8. 8.
    Yao HS, Wang Q, Wang WJ, Ruan CP (2009) Prospective clinical trials of thyroidectomy with LigaSure vs. conventional vessel ligation: a systematic review and meta-analysis. Arch Surg. PubMedCrossRefGoogle Scholar
  9. 9.
    Tan EK, Cornish J, Darzi AW, Papagrigoriadis S, Tekkis PP (2007) Meta-analysis of short-term outcomes of randomized controlled trials of LigaSure vs conventional hemorrhoidectomy. Arch Surg 142(12):1209–1218PubMedCrossRefGoogle Scholar
  10. 10.
    Guo T, Ren L, Wang Q, Li K (2016) A network meta-analysis of updated haemostatic strategies for hysterectomy. Int J Surg. PubMedCrossRefGoogle Scholar
  11. 11.
    Fromme GA, MacKenzie RA, JrAB Gould, Lund BA, Offord KP (1986) Controlled hypotension for orthognathic surgery. Anesth Analg 65:683–686PubMedCrossRefGoogle Scholar
  12. 12.
    Kiriakopoulos A, Dimitrios T, Dimitrios L (2004) Use of a diathermy system in thyroid surgery. Arch Surg 139:997–1000PubMedCrossRefGoogle Scholar
  13. 13.
    Petrakis IE, Kogerakis NE, Lasithiotakis KG, Vrachassotakis N, Chalkiadakis GE (2004) LigaSure versus clamp-and-tie thyroidectomy for benign nodular disease. Head Neck 26:903–909PubMedCrossRefGoogle Scholar
  14. 14.
    Manouras A, Markogiannakis H, Koutras AS, Antonakis PT, Drimousis P, Lagoudianakis EE et al (2008) Thyroid surgery: comparison between the electrothermal bipolar vessel sealing system, harmonic scalpel, and classic suture ligation. Am J Surg. PubMedCrossRefGoogle Scholar
  15. 15.
    Sartori PV, De Fina S, Colombo G, Pugliese F, Romano F, Cesana G et al (2008) Ligasure versus Ultracision® in thyroid surgery: a prospective randomized study. Langenbecks Arch Surg 393:655–658PubMedCrossRefGoogle Scholar
  16. 16.
    Franko J, Kish KJ, Pezzi CM, Pak H, Kukora JS (2006) Safely increasing the efficiency of thyroidectomy using a new bipolar electrosealing device (LigasureTM) versus conventional clamp-and-tie technique. Am Surg 72(2):132–136PubMedGoogle Scholar
  17. 17.
    Youssef T, Mahdy T, Farid M, Latif AA (2008) Thyroid surgery: use of the LigaSure vessel sealing system versus conventional knot tying. Int J Surg 6:323–327PubMedCrossRefGoogle Scholar
  18. 18.
    Prokopakis EP, Lachanas VA, Karatzanis AD, Benakis AA, Velegrakis GA (2005) How we do it: application of Ligasure vessel sealing system in patients undergoing total Laryngectomy and radical neck dissection. Clin Otolaryngol 30(2):198–201PubMedCrossRefGoogle Scholar
  19. 19.
    Thornton JA (1963) Estimation of blood loss during surgery. Ann R Coll Surg Engl 33(3):164–174PubMedPubMedCentralGoogle Scholar
  20. 20.
    Ozturk K, Kaya I, Turhal G, Ozturk A, Gursan G, Akyildiz S (2016) A comparison of electrothermal bipolar vessel sealing system and electrocautery in selective neck dissection. Eur Arch Otorhinolaryngol. PubMedCrossRefGoogle Scholar
  21. 21.
    Saint Marc O, Cogliandolo A, Piquard A, Famà F, Pidoto RR (2007) LigaSure vs. clamp-and-tie technique to achieve hemostasis in total thyroidectomy for benign multinodular goiter a prospective randomized study. Arch Surg 142:150–156PubMedCrossRefGoogle Scholar
  22. 22.
    Diamantis T, Kontos M, Arvelakis A, Syroukis S, Koronarchis D, Papalois A et al (2006) Comparison of monopolar electrocoagulation, bipolar electrocoagulation, Ultracision, and Ligasure. Surg Today 36:908–913PubMedCrossRefGoogle Scholar
  23. 23.
    Sutton PA, Awad S (2010) Comparison of lateral thermal spread using monopolar and bipolar diathermy, the Harmonic Scalpel™ and the Ligasure™. Br J Surg 97:428–433PubMedCrossRefGoogle Scholar
  24. 24.
    Tirelli G, Camilot D, Bonini P, Del Piero GC, Biasotto M, Quatela E (2015) Harmonic scalpel and electrothermal bipolar vessel sealing system in head and neck surgery: a prospective study on tissue heating and histological damage on nerves. Ann Otol Rhinol Laryngol 124(11):852–858PubMedCrossRefGoogle Scholar

Copyright information

© The Association of Oral and Maxillofacial Surgeons of India 2017

Authors and Affiliations

  1. 1.Department of Oral and Maxillofacial SurgerySCB Dental College and HospitalCuttackIndia
  2. 2.Department of Public Health DentistrySCB Dental College and HospitalCuttackIndia
  3. 3.Department of Prosthetic DentistrySCB Dental College and HospitalCuttackIndia

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