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Initial application of Ligasure in Head and Neck Surgery (06-05-2020 15:09)

Head and Neck surgery is relatively complicated, involving many important anatomical landmarks such as cranial nerves and large vessels. Bleeding control is one of the main goals during dissection. The application of Ligasure vessel sealing system in head and neck surgery was reported to be reliable and safe in several studies. Ligasure is able to achieve good hemostasis, reduce operation time, relieve post-operative pain, and recover quickly after surgery. This device was developed as an alternative to ligatures, hemoclips, staplers, and ultrasonic coagulators for ligating vessels and tissue bundles. When Ligasure clamps into the tissue bundle, it creates intracellular friction, disrupts Hydrogen Bridge, denatures proteins, and performs coagulation. Despite the high degree of heat produced between the jaws of the instrument, it does not produce a large amount of lateral heat. It also reduces the smoke production and adhesions, then damage to surrounding tissues is low. 


A couple of cases performed surgical procedures with use of Ligasure


Case 1: Neck dissection in patient with cancer of tonsil


A 64-year-old female presented to our department of Otolaryngology, Hue University of Medicine and Pharmacy Hospital with dysphagia and a right-sided palpable cervical mass. She has no specific medical history. The operative time was under one hour. Total postoperative neck drainage was less than 20ml. She was removed from 5.l-hemovac drainage on the second postop day. Her status was stable.


Case 2: Superficial parotidectomy with preservation of facial nerve


A 58-year-old male patient presented to the ENT Department, Hue University of Medicine and Pharmacy Hospital with a two-year gradually palpable mass at the left angle of mandibular. He has 20-year history of smoking. He underwent a surgery for superficial parotidectomy with facial nerve preservation. Permanent biopsied findings showed enlarged salivary glands and reactive proliferative lymph nodes with no malignant tissue. Postoperative findings noted no facial palsy; neck drainage was removed on the second postop day with < 5ml amount of fluid. He was discharged on the seventh postop day.


Case 3: Thyroidectomy with recurrent laryngeal nerve and parathyroid glands


A 53-year-old female was admitted to the hospital with a discomfort feeling on anterior neck which leads to mild dyspnea and dysphagia. Neck sonography showed a cystic mass measuring 50 x 90 mm in diameter on the left lobe of thyroid gland. She had performed left thyroid lobectomy and preserved recurrent laryngeal nerve and parathyroid glands with the use of Ligasure. The operative time was less than 30 minutes. Preliminary postop assessments were no hoarseness, no hematoma, mild postop pain, and good recovery after surgery.


A 37-year-old man presented to the hospital with a mass on the right-sided thyroid gland measuring 15x11x18mm in diameter. Sonography and cervical computer tomography revealed no neck metastasis. He underwent right lobectomy and isthmusectomy. Histological findings revealed well-differential papillary carcinoma. Postop status was no hoarseness, no hematoma, no postop pain.


Through the case summarized above, in the initial application of Ligasure in head and neck surgery, it is noted that Ligasure is a reliable, safe, and power device. This is an advance in the field of head and neck surgery which needs to be widely applied.


Dr. Phan Huu Ngoc Minh (Ph.D.)

                Department of Otolaryngology, University of Medicine and Pharmacy, Hue University

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