Kim Min Kuk, Lee Sangdal
MD Clinic, Breast Augmentation & Reconstruction Centre, Seoul, Republic of Korea.
Plast Reconstr Surg Glob Open. 2020 Dec 22;8(12):e3295. doi: 10.1097/GOX.0000000000003295. eCollection 2020 Dec.
The energy-based LigaSure device is widely utilized to facilitate dissection and hemostasis during various open and endoscopic procedures. Previous studies have demonstrated that this device can reduce intraoperative blood loss in various surgical settings. The present study aimed to report our experience with LigaSure and the advantages of using this device during transaxillary submuscular pocket dissection over those of a monopolar electrocautery dissector in patients undergoing breast augmentation.
A total of 156 patients who underwent transaxillary breast augmentation between November 2019 and May 2020 were retrospectively reviewed. Submuscular pocket dissection using LigaSure was performed in 92 patients and a conventional technique using a monopolar electrocautery dissector was performed in the remaining 64 patients. A bloodless breast pocket was defined as a clear operating field with little or no blood staining at any stage of the procedure. All endoscopic procedures were recorded to determine whether bloodless pockets had been established. The amount of postoperative drainage at 1 day after surgery was also assessed to compare between the LigaSure and conventional groups.
Bloodless breast pockets were successfully established in 83 patients (90.2%) in the LigaSure group and in 38 patients (59.4%) in the conventional group ( < 0.001). Postoperative drainage amount at 1 day following surgery was significantly lower in the LigaSure group than in the conventional group ( < 0.001).
Our findings indicate that the LigaSure system is a safe and effective alternative in breast augmentation requiring transaxillary submuscular dissection.
基于能量的LigaSure设备被广泛用于在各种开放手术和内镜手术中辅助解剖和止血。先前的研究表明，该设备在各种手术环境中均可减少术中失血。本研究旨在报告我们使用LigaSure的经验，以及在接受隆胸手术的患者中，经腋窝肌下口袋解剖时使用该设备相对于单极电灼解剖器的优势。
回顾性分析2019年11月至2020年5月期间接受经腋窝隆胸手术的156例患者。92例患者使用LigaSure进行肌下口袋解剖，其余64例患者采用传统的单极电灼解剖器技术。无血乳房口袋定义为在手术的任何阶段手术视野清晰、几乎没有或没有血染。记录所有内镜手术过程，以确定是否建立了无血口袋。还评估了术后1天的引流量，以比较LigaSure组和传统组。
LigaSure组83例患者（90.2%）成功建立了无血乳房口袋，传统组38例患者（59.4%）成功建立了无血乳房口袋（<0.001）。LigaSure组术后1天的引流量明显低于传统组（<0.001）。
我们的研究结果表明，LigaSure系统是需要经腋窝肌下解剖的隆胸手术中一种安全有效的替代方法。
