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Objective: To compare the safety and efficacy of the bipolar plasmakinetic vessel sealing versus standard technique while performing total abdominal hysterectomy for benign disease. Material and Methods: The study is a prospective, controlled trial involving 173 women who underwent total abdominal hysterectomy. Eighty procedures were performed using bipolar plasmakinetics vessel sealing and the remaining 93 with the standard suture technique. Both groups were compared in terms of their operative time, blood loss, postoperative pain scores, postoperative complications and the length of hospital stay. At the end of the operations, patients were given intravenous tramadol hydrochloride 1-1.5 mg/kg, and intramuscular 75 mg IM, 2x1 diclofenac sodium for postoperative analgesia. Pain scores of the patients were recorded postoperatively at 0 and 24 h. A visual analogue scale (VAS) in the range of 0-10 was utilized for scoring the patients. The statistical analysis was performed with SPSS 16.0 (Statistical Package for Social Sciences) for Windows. p<0.05 was considered statistically significant. Results: There were no statistically significant differences between two groups in terms of preoperative and postoperative hemoglobin values, postoperative complications or hospital stay. There were statistically significant differences between groups in terms of reduction (%) in hemoglobin levels, operation time and VAS scores at 0 and 24 h. The median reduction (%) in hemoglobin levels in the study group was -0.08% (min: -0.27-max: 0.10) compared to -0.08% (min: -0.29-max: 0.00) in the control group (p=0.033). The median operation time with LigaSure was 105 min (range70-175) compared to 130 min (range 60-230) with standard suture technique (p=0.001). In the study and control groups, the VAS scores at 0 h were 5 (min: 1max: 8) and 8 (min: 7max: 9) respectively (p=0.020), while at 24h they were 3 (min: 1max: 3) and 4 (min: 3max: 7), respectively (p=0.011). Conclusion: LigaSure is an effective and reliable device that provides a significant reduction in quantity of bleeding, reduction in operation time (approximately 15 min) and postoperative VAS scores.

turkiye klinikleri journal of medical sciences

Comparison of the Electrosurgical Bipolar Vessel Sealing with the Standard Suture Technique in Patients with Diverse Benign Indications for Abdominal Hysterectomy: A Controlled Trial