title: A randomized controlled study comparing harmonic versus electrosurgery in laparoscopic myomectomy.
abstract: OBJECTIVE
  To compare the effectiveness and safety of harmonic scalpel versus electrosurgery to reduce blood loss during laparoscopic myomectomy.
  
  
  METHODS
  Prospective randomized controlled study.
  
  
  METHODS
  Tertiary referral centers for gynecological care.
  
  
  METHODS
  One hundred sixty consecutive premenopausal women with symptomatic uterine leiomyomata who were assigned to one of the two treatment groups (a total of 80 patients in each group): treatment with electrosurgery devices with a vasoconstrictive solution (50 mL of saline solution and 0.5 mL of epinephrine [1/2 vial of 1 mg/mL]; group A) or harmonic scalpel (group B).
  
  
  METHODS
  Laparoscopic myomectomy.
  
  
  METHODS
  The global operative time, the time spent for myoma enucleation and for suturing uterine wall defects, and intraoperative blood loss as well as the surgical difficulty degree and postoperative pain at 24 and 48 hours after the laparoscopic procedure.
  
  
  RESULTS
  No relevant intra- or postoperative complications were observed in either group. The degree of pain 24 hours after surgery was significantly lower in patients in whom the harmonic scalpel was used. The degree of surgical difficulty did not differ between groups, but the global operative time was significantly shorter in the harmonic scalpel group.
  
  
  CONCLUSIONS
  The use of the harmonic scalpel for laparoscopic myomectomy is associated with low total operative time, low intraoperative blood loss, and low postoperative pain, with no increase in surgical difficulty.
authors.affiliation: Department of Gynecological Science and Human Reproduction, University of Padua, School of Medicine, Padua, Italy.
authors.forename: Pietro
authors.initials: P
authors.lastname: Litta
authors.forename: Sara
authors.initials: S
authors.lastname: Fantinato
authors.forename: Francesco
authors.initials: F
authors.lastname: Calonaci
authors.forename: Erich
authors.initials: E
authors.lastname: Cosmi
authors.forename: Marco
authors.initials: M
authors.lastname: Filippeschi
authors.forename: Irene
authors.initials: I
authors.lastname: Zerbetto
authors.forename: Felice
authors.initials: F
authors.lastname: Petraglia
authors.forename: Pasquale
authors.initials: P
authors.lastname: Florio
mesh_terms: D000328:Adult; D016063:Blood Loss, Surgical; D004598:Electrosurgery / Q000009:adverse effects / Q000379:methods*; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D053685:Laser Therapy / Q000009:adverse effects / Q000379:methods*; D007889:Leiomyoma / Q000601:surgery*; D019106:Postoperative Hemorrhage; D011446:Prospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D014594:Uterine Neoplasms / Q000601:surgery*