A randomized controlled study comparing harmonic versus electrosurgery in laparoscopic myomectomy.
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.
Litta
Pietro
P
Department of Gynecological Science and Human Reproduction, University of Padua, School of Medicine, Padua, Italy.
Fantinato
Sara
S
Calonaci
Francesco
F
Cosmi
Erich
E
Filippeschi
Marco
M
Zerbetto
Irene
I
Petraglia
Felice
F
Florio
Pasquale
P
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*