Update on laparoscopic electrosurgical devices and their use in complex urologic procedures

• Published in: Progrès en urologie (Paris) Vol. 27; no. 5; p. 267
• Main Authors: Boukheir, G, Aoun, F, Albisinni, S, Roumeguère, T
• Format: Journal Article
• Language: French
• Published: France 01-04-2017
• Subjects: Blood Loss, Surgical - prevention & control; Electrosurgery - methods; Humans; Kidney Neoplasms - surgery; Laparoscopy - methods; Male; Nephrectomy - methods; Prostatectomy - methods; Treatment Outcome; Urologic Surgical Procedures - methods; Urology; Développement technologique; Nephrectomy; Radical prostatectomy; Néphrectomie; Laparoscopic electrosurgery; Électrochirurgie laparoscopique; Prostatectomie totale; Technological advances
• ISSN: 1166-7087
• DOI: 10.1016/j.purol.2017.02.002

Laparoscopy is the standard of care for many urologic procedures and witnesses nowadays technological advancements. Hemostasis is highly important in laparoscopy since bleeding could rapidly alter the operative conditions. The objective of this review is to expose the different electrosurgical techniques, their history and their applications in urology.
A literature review was overdone using the following terms "laparoscopic electrosurgery" and/or "nephrectomy" and/or "prostatectomy". Two hundred and forty articles were found through Pubmed. After reviewing the title and the content of these articles, 18 were eligible for the following review.
The different electrosurgical techniques and their technological evolution are exposed. Physical properties of each system are exposed as well. Advantages and limitations of each system are also reviewed and analyzed.
Bipolar electrosurgery with thermofusion and ultrasound technology can achieve good results in terms of nerve sparing for radical laparoscopic prostatectomies. They can both be used in partial nephrectomies. However, they can compromise the surgical resection margins. Hybrid systems seem to have an important role in urological laparoscopic procedures despite the scarce number of available studies.
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