Overall Score: 1. This drive for added value is distinctly apparent in this new tool. The technology is rated to seal vessels up to 7 mm in diameter while keeping its footprint to less than 2 mm. To this end, the engineers gave us the LigaSure Advance.
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Overall Score: 1. This drive for added value is distinctly apparent in this new tool. The technology is rated to seal vessels up to 7 mm in diameter while keeping its footprint to less than 2 mm.
To this end, the engineers gave us the LigaSure Advance. It seals vessels, cuts tissue, and dissects tissue planes. The device is designed to be the only tool any surgeon will ever need. In theory, the LigaSure Advance has the capability to do all these things. However, in testing, the device was a bit of a disappointment. In fairness, this may simply be a reflection of the fact that the newer design moves away from the more traditional pistol grip to which most surgeons are accustomed, but none of the surgeons who tried it liked it better than the older style.
Second, jaws retain the same low friction platform common in all the LigaSure laparoscopic devices. This allows tissue to slip out of the jaws too frequently. Finally, and most troublingly, the cramming in of so much technology at the tip creates some problems.
In particular, after several uses to seal vessels, the coagulum buildup on the tip can prevent the jaws from opening and closing completely; this in turn disables a safety mechanism on the cutting blades. Innovation Score: 1. If a surgeon can safely and efficiently perform surgeries without the disposable devices—and some can—then they are all poor value.
If a given surgeon is able to get everything out of the device that it is supposed to deliver coagulation, cutting, dissecting, and grasping there may be some added value, but at that retail price, even that is a stretch. Value Score: 1. For those surgeons who are accustomed to and comfortable with the older LigaSure laparoscopic devices, this newer option is unlikely to offer enough to make them switch. Greenberg reports no personal financial relationships with any of the companies whose products he reviews in this column.
References 1. LigaSure tissue fusion system Web site. Greenberg JA. Rev Obstet Gynecol.
Prospective comparison of four laparoscopic vessel ligation devices. J Endourol. Use of LigaSure bipolar diathermy system in vaginal hysterectomy. J Obstet Gynaecol.