Safety and efficacy of using the LigaSure vessel sealing system for securing the pedicles in vaginal hysterectomy: randomised controlled trial.
OBJECTIVE
To assess the safety and efficacy of using the LigaSure vessel sealing system for securing the pedicles during vaginal hysterectomy in comparison with the conventional method of securing the pedicles by suture ligation.


METHODS
Randomised controlled trial.


METHODS
Gynaecology Department, Benenden Hospital, Kent.


METHODS
One hundred and sixteen women undergoing vaginal hysterectomy were prospectively randomised to either LigaSure (Group I) or suture ligation (Group II) for securing the pedicles.


METHODS
Data of patients were collected prospectively. Statistical analysis was performed using the Mann-Whitney U test, chi(2) and Fisher's exact test as appropriate.


METHODS
Operating time, operative blood loss and peri-operative complications.


RESULTS
The operating time was significantly shorter in the LigaSure group compared with the control group (P < 0.04). There was no statistical significant difference between the two groups in operative blood loss (P= 0.433), but peri-operative haemorrhagic complications were less frequent in the LigaSure group (0%vs 6.8%, P= 0.057). Four patients in the control group required either conversion to laparotomy because of bleeding, return to theatre for immediate post-operative haemorrhage or readmission for vault haematoma, whereas none in the LigaSure group had bleeding from unsecured pedicles.


CONCLUSIONS
The LigaSure vessel sealing system is a safe alternative for securing pedicles in vaginal hysterectomy when compared with conventional suture ligation. Larger studies are required to determine its place in gynaecological surgery.
Hefni
M A
MA
Department of Gynaecology, Benenden Hospital, Kent TN17 7AX, UK.
Bhaumik
J
J
El-Toukhy
T
T
Kho
P
P
Wong
I
I
Abdel-Razik
T
T
Davies
A E
AE
D016063:Blood Loss, Surgical / Q000517:prevention & control; D017115:Catheter Ablation / Q000295:instrumentation* / Q000379:methods; D004867:Equipment Design; D005260:Female; D006488:Hemostasis, Surgical / Q000295:instrumentation*; D006801:Humans; D007045:Hysterectomy, Vaginal / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods; D007431:Intraoperative Complications / Q000209:etiology / Q000517:prevention & control; D007902:Length of Stay; D008026:Ligation / Q000295:instrumentation / Q000379:methods; D008875:Middle Aged; D011446:Prospective Studies; D013536:Suture Techniques; D016896:Treatment Outcome; D001743:Urinary Bladder / Q000293:injuries