Comparative Study of Electrosurgical Bipolar Vessel Sealing Using Ligasure versus Conventional Suturing for Total Abdominal Hysterectomy

Abstract

Background: Hysterectomy is a common gynecological surgical intervention, which could be associated with increased female morbidity and mortality. Bleeding and pain represent two main complications associated with hysterectomy. Hemostatic measures are in a continuous development, and LigaSure could represent one of the most important milestones in this field. Aim of the work:To compare LigaSure use versus conventional suturing in total abdominal hysterectomy. Patients and Methods:Seventy patients who were scheduled for elective hysterectomy were included. They were assigned to equal groups [Ligasure [A] and Conventional suturing [B]]. All were screened preoperatively, prepared and both intra-and post-operative outcome were registered and compared between both groups [mainly blood loss and postoperative pain]. Results: Both groups were comparable as regard to patient age, body mass index, parity, and indications for hysterectomy. Operative time was significantly reduced among vessel sealing when compared to conventional group [54.9±6.7 vs 63.1±6.6 minutes respectively]. In addition, vessels sealing group was associated with significantly low blood loss [142.7±23.1 vs 285.7±28.4 ml], high postoperative hemoglobin [11.3±1.0 vs 11.0±0.9], low hemoglobin reduction, and significant reduction of postoperative pain at evening, first and second postoperative days and low need for analgesia. Conclusion: Electrosurgical bipolar vessel sealing is an effective alternative to sutures in abdominal hysterectomy. It is associated with significant operative time shortening, low blood loss and low postoperative pain.

Keywords

• hysterectomy
• bleeding
• ligasure
• sutures
• complications