Pelvic Lymph Node Dissection With Polymer Ligation Clips Significantly Reduces Hospital Stay Compared to Vessel Sealer: A Retrospective Study

Introduction Lymphocele is a typical complication of pelvic lymph node dissection (PLND) in robot-assisted radical prostatectomy (RARP). This study aimed to compare postoperative lymphatic leakage between the polymer ligation clip and vessel sealer, and evaluated the costs associated with the former. Methods The study enrolled patients who underwent RARP with PLND at our institution between April 2018 and March 2023 and were treated with a vessel sealer (LigaSure Blunt Tip 44 NC^TM; Medtronic, Dublin, Ireland) until September 2021, and Hem-o-lok polymer ligation clips^TM(Teleflex, Wayne, PA, USA) thereafter. The drain was removed on the third postoperative day or later, when the daily drainage volume was less than 200 mL. Results A total of 81 patients underwent RARP with PLND, which resulted in a significant increase in the operative (p = 0.016) and lymph node dissection times (p = 0.008) in the clip group. The total drainage volume (p = 0.048) was smaller, and the drain removal time (p = 0.039) and postoperative hospital stay (p < 0.001) were shorter in the clip group. Moreover, the device costs for the clips were lower than those for the vessel sealer. Conclusion Polymer ligation clips are associated with improved postoperative lymphatic leakage, shorter length of hospitalization, and lower costs, compared with vessel sealers.