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Ultrasonic Dissection Versus Conventional Dissection Techniques in Pancreatic Surgery: A Randomized Multicentre Study

Uzunoglu, Faik G. MD*; Stehr, Anne MD*; Fink, Judith A. MD*; Vettorazzi, Eik; Koenig, Alexandra MD*; Gawad, Karim A. MD*; Vashist, Yogesh K. MD*; Kutup, Asad MD*; Mann, Oliver MD*; Gavazzi, Francesca MD; Zerbi, Alessandro MD; Bassi, Claudio MD; Dervenis, Christos MD§; Montorsi, Marco MD; Bockhorn, Maximilian MD*; Izbicki, Jakob R. MD*

doi: 10.1097/SLA.0b013e318271cefa
Original Articles From the ESA Proceedings

Objective: This prospective randomized multicenter trial was performed to assess the potential benefits of ultrasonic energy dissection compared with conventional dissection techniques in pancreatic surgery.

Background: Surgical procedures for tumors of the pancreatic head involve time-consuming manual dissection. The primary hypothesis was that use of ultrasonic tissue and vessel dissection would lead to substantial saving in operative time during pancreatic resection.

Methods: Patients eligible for pancreaticoduodenectomy (PD) or pylorus-preserving PD (PPPD) were randomized to group A (dissection with ultrasonic device) or group B (conventional dissection) from March 2009 to May 2011. The primary endpoint was overall duration of operation time. Secondary endpoints were time to end of resection phase, intraoperative blood loss, number of transfused units of blood, and postoperative morbidity.

Results: Analysis of primary and secondary endpoints included 101 patients, who received either PD or PPPD. Demographical characteristics and clinical parameters were similar in both groups. The use of an ultrasonic dissection device did not significantly reduce overall operation time (median 316 minutes in group A and 319 minutes in group B, P = 0.95) and did not significantly increase the costs of surgery. Analysis of secondary endpoints revealed no difference in postoperative course.

Conclusions: Tissue dissection and vessel closure using an ultrasonic device is equivalent to dissection with conventional techniques in pancreatic surgery.

The aim of this randomized multicenter trial was to assess the potential advantage of ultrasonic dissection in pancreatic surgery. Tissue dissection and vessel closure using an ultrasonic device was equivalent to dissection with conventional techniques in pancreatic surgery.

*Department of General, Visceral and Thoracic Surgery, University Medical Centre Hamburg-Eppendorf, Martinistraße 52, 20246 Hamburg, Germany

Department of General Surgery, University of Milan, Instituto Clinico Humanitas IRCCS, via Manzoni 56, 20089 Rozzano, Milan, Italy

Surgical and Gastroenterological Department, Borgo Roma Hospital, University of Verona, 37134 Verona, Italy

§1st Department of Surgery, Agia Olga Hospital, Agias Olgas 3–5, 14233 Athens, Greece

Department of Medical Biometry and Epidemiology, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany.

Reprints will be not available from authors.

Disclosure: Financial support was obtained from Ethicon, Johnson & Johnson, Norderstedt, Germany. There are no personal conflicts of interest of any of the authors.

© 2012 Lippincott Williams & Wilkins, Inc.