The Covidien LigaSure Maryland Jaw Device

Abstract

Since its invention nearly 20 years ago, the Covidien LigaSure device along with its ForceTriad generator has dominated the Electrothermal Bipolar Vessel Sealing market. The LigaSure was used for surgical procedures, both open and laparoscopic. The purpose of this review is to provide evidence of the safety and utility of the LigaSure device compared to more traditional means of hemostasis and its ultrasonic competitor, particularly in laparoscopic applications. We will provide evidence related to electrothermal bipolar vessel sealing in general and look specifically at Covidien’s newest product, the LigaSure Maryland Jaw Device.

Keywords:

• conventional hemostasis
• cost-analysis
• electrothermal bipolar vessel sealing technology
• laparoscopic surgery
• LigaSure
• ultrasonic dissector

Financial & competing interests disclosure

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

No writing assistance was utilized in the production of this manuscript.

Key issues

• The LigaSure devices along with ForceTriad generator allow for safe and efficient hemostasis of vessels up to 7 mm.

• Use of the LigaSure devices may be associated with less intra-operative blood loss when compared to traditional knot-tying and monopolar cautery devices, although this difference may not be clinically significant.

• Intraoperative blood loss using the LigaSure devices is likely similar to blood loss using ultrasonic dissectors, although some studies appear to favor the LigaSure.

• The LigaSure devices significantly reduce operating time without compromising safety or operative outcome.

• The reduction in operating time may translate to significant overall cost-benefit.

• The risk of lateral thermal spread remains despite various improvements in technology. Lateral spread is likely 3 mm or less but can vary according to tissue type.

• The LigaSure Maryland Jaw Sealer/Divider introduces a significant change in pistol design. These changes may require a learning curve with the potential for complications.

• Future devices will need to minimize lateral spread and maintain cost-effective, likely with the introduction of reusable instruments.