112: Impact of vessel sealing device on outcome of radical cystectomy.

Introduction: To evaluate the role of an electrothermal bipolar coagulator (Biclamp) on the performance and outcome of open radical cystectomy in comparison with conventional methods of dissection. Methods: Over 1 year period, a prospective study was carried out in patients undergoing open radical cystectomy and urinary diversion for muscle invasive carcinoma bladder employing either conventional ligation/clip in the control group (n=22) or Biclamp device in the study group (n=20). Biclamp was used to divide the posterior and lateral pedicles of bladder. Outcome measures evaluated were estimated blood loss (EBL), transfusion requirement, operating time (total/cystectomy) and postoperative variables such as analgesia requirement, time to drain removal, duration of hospital stay and incidence of complications in both the groups. Results: Both groups were similar with regards to age, sex, BMI, associated co morbidity and clinical stage of the disease. Mean EBL and transfusion requirement in study and control groups were 605 and 1116 ml (P= 0.03) and 1.4 and 2.9 units (P=0.008), respectively. Mean cystectomy and total operating time were 74 and 104 minutes (P=0.02) and 295 and 304 minutes (P=0.76) in study and control groups, respectively. There was no significant difference in respect to analgesic requirement, drain removal, duration of hospital stay and incidence of complication between the groups. Conclusions: Use of Biclamp in radical cystectomy reduces blood loss,saves operating time and is particularly useful in dividing vessels deep in the pelvis where it acts as an viable alternative to hemostatic clips and sutures. [ABSTRACT FROM AUTHOR]