Abstract
BackgroundThe optimal dissection technique for flap elevation in abdominoplasty remains debated, particularly in high-risk patients after massive weight loss. The LigaSure Impact™ (LS) vessel-sealing system (Medtronic, Dublin, Ireland) is an advanced energy device used across surgical disciplines to reduce morbidity. This meta-analysis compares LS with conventional techniques to assess its effectiveness in abdominoplasty.MethodA systematic literature search identified relevant studies comparing LS with standard methods. Primary outcome was the overall postoperative complications' rate; secondary outcomes included specific wound complications, operative time, and hospital stay.StatisticsA random-effects model was used for pooled analysis. Risk differences (RD) and 95% confidence intervals (CI) were calculated for categorical outcomes; mean differences (MD) for continuous outcomes. Heterogeneity was assessed using the I(2) statistic.ResultsThe search yielded 3 studies totaling 205 patients. LS significantly reduced overall complication rates compared to controls (RD = -0.46, 95% CI: -0.60 to -0.32, P < 0.001). Hematoma and wound dehiscence incidences were significantly lower (P = 0.03 and P = 0.01, respectively). No significant differences were observed for seroma, infection, or fat/flap necrosis. LS use was also associated with reduced re-operation rates and shorter hospital stays, though operative time was comparable.DiscussionLS may improve surgical outcomes in post-weight-loss abdominoplasty patients by reducing complications and hospitalization. However, the limited number of studies and small sample size warrant cautious interpretation.ConclusionPreliminary evidence suggests that LS may offer potential benefits in abdominoplasty; however, current findings should be interpreted with caution because of limited quality and heterogeneity of available studies. Further research is needed.