Ultrasonic Instruments Linked to Some Surgical Benefits

Blood loss, surgery time, bleeding complication advantages seen in some procedures

THURSDAY, June 19 (HealthDay News) -- The use of ultrasonic surgical instrumentation such as scalpels and shears is safe and effective in a variety of surgical procedures, and is associated with some procedure-specific advantages, researchers report in the June Archives of Surgery.

Brent Matthews, M.D., of the Washington University School of Medicine in St. Louis, and colleagues conducted a systematic review and meta-analysis of 51 studies involving 4,902 patients, comparing the efficacy and safety of ultrasonic surgical instrumentation with non-ultrasonic traditional techniques, such as monopolar or bipolar cautery and conventional clamp or tie techniques.

Mean blood loss appeared to be lower for most general procedures with ultrasonic instrumentation, except for colorectal and Nissen fundoplication procedures, the investigators found. Average surgery time with ultrasonic instrumentation appeared to be shorter, except for during mastectomy; a significant difference in favor of ultrasonic instrumentation was seen in cholecystectomy and head and neck surgery. For all studies and procedures that contributed data on bleeding, fewer patients in the ultrasonic group appeared to have bleeding complications, except in colorectal surgeries, the report indicates.

"The expanded use of ultrasonic instrumentation in general or minimally invasive surgery, colorectal surgery, gynecologic surgery, plastic and reconstructive surgery, and otolaryngology is supported by the outcomes from this systematic review. A decrease in operative blood loss combined with less local thermal damage than traditional electrosurgical instrumentation may prove to be of particular benefit in selected surgical procedures," the authors write.

The study was supported by Ethicon Endo-Surgery.

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