Usefulness of the LigaSure™ small jaw sealing device for breast reconstruction with a latissimus dorsi flap

Abstract

Background: Seromas are the most common complication of latissimus dorsi flap breast reconstruction. Electrocautery for flap elevation can cause seromas and injure the lymph or vessels of the surrounding tissues. Positive effects of the LigaSure Small Jaw (Medtronic [formerly Covidien], Minneapolis, MN, USA) sealing device were examined.

Methods: Forty-three latissimus dorsi flap breast reconstruction patients were included. Twenty-three underwent surgery with electrocautery and 21 underwent surgery with LigaSure. The seroma formation rate, total drain volume, drainage indwelling periods at the breast site and donor site, operative time, and hospital stay duration were retrospectively compared. Associations between patient characteristics and these variables were analyzed.

Results: Seroma incidence rates were 9/23 (39.1%) and 3/21 (14.3%) for the control and experimental groups. One control group patient underwent surgical treatment; the rest underwent conservative treatment. A significant difference in latissimus dorsi flap elevation time was found between the control and experimental groups (105.6 minutes and 77.1 minutes; p = .026). A significant difference in the drainage indwelling periods of the latissimus dorsi donor site was found (13.1 days and 11 days; p = .006). Excised breast mass weight, latissimus dorsi flap weight, breast drain total volume/indwelling period, and latissimus dorsi drain volume/indwelling period showed statistically significant associations. Radiation and chemotherapy were not significantly associated with any variables.

Conclusion: The LigaSure device for latissimus dorsi flap breast reconstruction can reduce seromas, operative time, and hospital stay. It is a reliable and useful surgical sealing device that does not cause injury to the surrounding tissues.

Keywords:

• Breast reconstruction
• latissimus dorsi flap
• surgical sealing device
• seroma
• LigaSure

Disclosure statement

The authors report no conflicts of interest.