Introduction/Background*Cytoreductive surgery is the cornerstone treatment in the armamentarium for women with advanced ovarian cancer. The goal of successful cytoreduction is achiving no visible tumor or residual disease less than 1 cm. This prerequisite is a demanding process with high morbidity, requiring high clinical expertise and enhanced surgical skills. The objective of the presented analysis is to identify whether the usage of the Ligasure® Maryland jaw open sealer/divider (LMjsd) with nanocoating facilitates cytoreductive surgery by reducing intraoperative bleeding and hence other parameters regarding hospitalization.

Methodology Women with advanced stage ovarian cancer (stage III or IV) who were referred to the Department of Gynecologic Oncology, 1st Department of Obstetrics and Gynecology, Papageorgiou General Hospital, Thessaloniki, Greece, and were subjected to either primary or interval cytoreductive surgery were included in the analysis. Women, who were operated on by the same group of Gynecologic Oncologists, were retrospectively allocated into two distinct groups comprised of women subjected to surgery with or without using the LMjsd. The analysis focused on differences between the two groups regarding intraoperative blood loss and blood transfusion, duration of surgery, blood transfusion within the post-operative course, Intensive Care Unit (ICU) and overall hospital length of stay.

Result(s)*Between 2012 and 2020, 284 women with ovarian cancer were subjected to surgery; of these, 208 had ovarian cancer stage III or IV. In the group of women (N=34), who were operated on using the LMjsd, duration of surgery, and blood loss during surgery were significantly decreased (p<0.0005 for both parameters) compared to cases treated without the LMjsd (N=174) . The intra-operative blood transfusion rate and the number of units of packed red blood cells given to the patients were significantly decreased in the first group (p=0.0025), whereas post-operative blood transfusion rate was not affected (p=0.065). Moreover, ICU and overall hospital length of stay were significantly decreased in cases where the LMjsd was used (p<0.0005 and p=0.015).

Conclusion*The LMjsd with nanocoating reduces intra-operative bleeding and transfusion rates, and improves duration of surgery, and ICU and overall hospital length of stay in women subjected to cytoreductive surgery for advanced ovarian cancer.