Background: Advanced laparoscopic solid organ surgery is now possible with the use of LigaSure and the Harmonic scalpel, which drastically cut down on operating time and blood loss. This work aimed for comparing the effectiveness of Ligasure or Ultracision in Laparoscopic Splenectomy (LS) regarding dissection, operative time and blood loss.

Subjects and methods: in this randomized prospective clinical trial 36 patients candidate for LS were randomized into two groups (18 patients in each group): in Group A LS was performed and Group B Harmonic was perfrormed . Intra-operative measures/difficulties (Operative time, occurrence of bleeding/ blood loss, presence of accessory spleen, need for intraoperative blood transfusion) were assessed in addition to postoperative hospital stay.

Results: In the Ligasure group, No intraoperative encountered difficulties (0%), while in the Harmonic group, 5 cases (27.78%) experienced such issues, representing a significant increase (p = 0.0152). The Ligasure group had statistically shorter operation time compared to the harmonic group (124.94 ± 16.24 vs. 149.28 ± 12.87, p < 0.0001). Intraoperative blood loss was also statistically lower in the Ligasure group (81.67 ± 19.22 vs. 124.17 ± 14.55, p < 0.001), the Ligasure patients required significantly less blood transfusions intraoperatively (0% vs. 22.22%, p = 0.1039).

Conclusion: When it comes to benign haematological problems, LS should always be the primary option for spleen removal. LigaSure and Ultracision both could offer important advantages in laparoscopy. Using LigaSure in LS reduced the operative time, blood loss and the need for intraoperative blood transfusion.