Electrothermal bipolar coagulation for pelvic exenterations

Objectives.: The morbidity associated with pelvic exenteration is high; however, patients undergoing this procedure have no other curative treatment options. Excessive blood loss is a common complication of this procedure. We evaluated whether use of an electrothermal bipolar coagulator (LigaSure Atlas, ValleyLab, Boulder, Colorado, USA) during pelvic exenteration is safe and whether it reduces intraoperative blood loss, intraoperative blood transfusion requirements, and length of hospital stay. Methods.: Between September 2003 and January 2005, 12 patients underwent pelvic exenteration (total, anterior, or posterior) performed using the electrothermal bipolar coagulator. Estimated blood loss, transfusion requirements, length of hospital stay, and complications necessitating reoperation were evaluated. Results.: The mean age was 55 years (range, 30-77), the mean estimated blood loss was 1931 ml (range, 1300-1500 ml), the mean number of units of packed red blood cells transfused intraoperatively was 3.4 U (range, 2-12 U), the mean operative time was 609 min (range, 400-940 min), and the mean length of hospital stay was 19.9 days (range, 7-27). There were no intraoperative complications related to the electrothermal bipolar coagulator use. None of the patients had any complications necessitating reoperation. Conclusions.: Use of the electrothermal bipolar coagulator device during pelvic exenteration is safe and may decrease blood loss and the number of units of blood that must be transfused intraoperatively.