Clipless laparoscopic restorative proctocolectomy using an electrothermal bipolar vessel sealer

Background: Recently, a new type of laparoscopic electrothermal bipolar vessel sealer (EBVS; LigaSure Atlas) was developed. The aim of the present study was to describe the feasibility and effectiveness of LigaSure Atlas in laparoscopic restorative proctocolectomy for patients with ulcerative colitis. Methods: Between January and December 2002, eight patients with ulcerative colitis underwent laparoscopic restorative proctocolectomy. The median age was 30 (range: 18-51) years and median follow up was 6 (range: 1-13) months. The entire procedure was performed using only LigaSure Atlas and diathermy, without using conventional hemoclips or ultrasonic coagulating shears. Results: There were no conversions to the open procedure. There were no intraoperative or postoperative hemorrhagic complications. The operative time was reduced by 40 min compared with the conventional laparoscopic procedure, and the cost was 350 US dollars less compared with the method using conventional hemoclips and ultrasonic coagulating shears. Conclusion: The laparoscopic restorative proctocolectomy using LigaSure Atlas is safe, feasible and cost-effective in selected patients with ulcerative colitis.