Contemporary use of ultrasonic versus standard electrosurgical dissection in laparoscopic nephrectomy: Safety, efficacy and cost

Objective: To assess the safety, efficacy and cost-effectiveness of ultrasonic dissection (USD) compared with standard monopolar electrosurgery (ES) in laparoscopic nephrectomy (LN). Patients and methods: Retrospective analysis of patients’ records who underwent elective LN was performed. Patients w...

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Autores principales:	Nand Kishore Arvind, Qutubuddin Ali, Onkar Singh, Shilpi Gupta, Surbhi Sahay
Formato:	article
Lenguaje:	EN
Publicado:	Taylor & Francis Group 2018
Materias:	Diseases of the genitourinary system. Urology RC870-923
Acceso en línea:	https://doaj.org/article/7319b1adc26242e18560903717d8539b
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spelling	oai:doaj.org-article:7319b1adc26242e18560903717d8539b2021-12-02T10:23:51ZContemporary use of ultrasonic versus standard electrosurgical dissection in laparoscopic nephrectomy: Safety, efficacy and cost2090-598X10.1016/j.aju.2018.05.003https://doaj.org/article/7319b1adc26242e18560903717d8539b2018-09-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S2090598X18300585https://doaj.org/toc/2090-598XObjective: To assess the safety, efficacy and cost-effectiveness of ultrasonic dissection (USD) compared with standard monopolar electrosurgery (ES) in laparoscopic nephrectomy (LN). Patients and methods: Retrospective analysis of patients’ records who underwent elective LN was performed. Patients were divided in to two groups: USD and ES groups depending on the energy source used during LN. The preoperative (demographics, indication for surgery), intraoperative (conversion to open surgery, operative time, estimated blood loss [EBL], complications), and postoperative (morbidity/mortality, volume of drainage, hospital stay, cost) data were collected and analysed. Results: Between February 2004 and February 2008, 136 patients were included. The indications for nephrectomy were: inflammatory (51 patients), non-inflammatory (64), and tumours (21). The two groups were similar for preoperative data. The conversion rate to open surgery (12.5%) and mean operative time did not differ significantly between the groups. However, intraoperative mean EBL was significantly less with USD, at 140.8 mL vs 182.6 mL for ES. There were no differences in postoperative parameters and morbidity. USD was significantly more expensive than ES (59 000 vs 26 000 Indian Rupees). Conclusions: ES is a safe and feasible tool like USD in LN when used with caution. USD facilitates completion of difficult cases and reduces intraoperative blood loss. However, the majority of LNs can be completed safely with ES. ES is sturdy and cheap; therefore, selective use of USD appears to be the most cost-effective policy in the developing world. Keywords: Ultrasonic scalpel, Harmonic dissection, Monopolar electrosurgery, Laparoscopic nephrectomy, CostNand Kishore ArvindQutubuddin AliOnkar SinghShilpi GuptaSurbhi SahayTaylor & Francis GrouparticleDiseases of the genitourinary system. UrologyRC870-923ENArab Journal of Urology, Vol 16, Iss 3, Pp 335-341 (2018)
institution	DOAJ
collection	DOAJ
language	EN
topic	Diseases of the genitourinary system. Urology RC870-923
spellingShingle	Diseases of the genitourinary system. Urology RC870-923 Nand Kishore Arvind Qutubuddin Ali Onkar Singh Shilpi Gupta Surbhi Sahay Contemporary use of ultrasonic versus standard electrosurgical dissection in laparoscopic nephrectomy: Safety, efficacy and cost
description	Objective: To assess the safety, efficacy and cost-effectiveness of ultrasonic dissection (USD) compared with standard monopolar electrosurgery (ES) in laparoscopic nephrectomy (LN). Patients and methods: Retrospective analysis of patients’ records who underwent elective LN was performed. Patients were divided in to two groups: USD and ES groups depending on the energy source used during LN. The preoperative (demographics, indication for surgery), intraoperative (conversion to open surgery, operative time, estimated blood loss [EBL], complications), and postoperative (morbidity/mortality, volume of drainage, hospital stay, cost) data were collected and analysed. Results: Between February 2004 and February 2008, 136 patients were included. The indications for nephrectomy were: inflammatory (51 patients), non-inflammatory (64), and tumours (21). The two groups were similar for preoperative data. The conversion rate to open surgery (12.5%) and mean operative time did not differ significantly between the groups. However, intraoperative mean EBL was significantly less with USD, at 140.8 mL vs 182.6 mL for ES. There were no differences in postoperative parameters and morbidity. USD was significantly more expensive than ES (59 000 vs 26 000 Indian Rupees). Conclusions: ES is a safe and feasible tool like USD in LN when used with caution. USD facilitates completion of difficult cases and reduces intraoperative blood loss. However, the majority of LNs can be completed safely with ES. ES is sturdy and cheap; therefore, selective use of USD appears to be the most cost-effective policy in the developing world. Keywords: Ultrasonic scalpel, Harmonic dissection, Monopolar electrosurgery, Laparoscopic nephrectomy, Cost
format	article
author	Nand Kishore Arvind Qutubuddin Ali Onkar Singh Shilpi Gupta Surbhi Sahay
author_facet	Nand Kishore Arvind Qutubuddin Ali Onkar Singh Shilpi Gupta Surbhi Sahay
author_sort	Nand Kishore Arvind
title	Contemporary use of ultrasonic versus standard electrosurgical dissection in laparoscopic nephrectomy: Safety, efficacy and cost
title_short	Contemporary use of ultrasonic versus standard electrosurgical dissection in laparoscopic nephrectomy: Safety, efficacy and cost
title_full	Contemporary use of ultrasonic versus standard electrosurgical dissection in laparoscopic nephrectomy: Safety, efficacy and cost
title_fullStr	Contemporary use of ultrasonic versus standard electrosurgical dissection in laparoscopic nephrectomy: Safety, efficacy and cost
title_full_unstemmed	Contemporary use of ultrasonic versus standard electrosurgical dissection in laparoscopic nephrectomy: Safety, efficacy and cost
title_sort	contemporary use of ultrasonic versus standard electrosurgical dissection in laparoscopic nephrectomy: safety, efficacy and cost
publisher	Taylor & Francis Group
publishDate	2018
url	https://doaj.org/article/7319b1adc26242e18560903717d8539b
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Contemporary use of ultrasonic versus standard electrosurgical dissection in laparoscopic nephrectomy: Safety, efficacy and cost

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