Bipolar vessel sealing increases operative safety in laparoscopic-assisted vaginal hysterectomy.
BACKGROUND
To compare laparoscopic-assisted vaginal hysterectomy (LAVH) with and without bipolar vessel sealing (BVS) using the LigaSure™ device by meanings of intra- and postoperative course.


METHODS
In a retrospective case-control study 362 female patients (mean age 54.3 ± 9.5 years) were included who underwent LAVH with (n = 252) and without (n = 110) use of BVS. Intra- and postoperative courses and adverse events were evaluated.


RESULTS
A shorter mean operating time was found for LAVH with the use of BVS (65.28 ± 16.33 min) when compared with LAVH without the use of BVS (83.73 ± 21.53 min, P < 0.005). The mean postoperative stay did not differ significantly between the two groups (P > 0.05); 15 out of 251 (6.0%) patients were found to have adverse events during or after LAVH with the use of BVS in contrast to 16 out of 110 (14.5%) patients during or after LAVH without the use of BVS (P < 0.05). Following the use of BVS significantly less patients reported postoperative pain for more than 7 days after the operation in contrast to the use of sutures (0/251 [0%] vs. 3/110 [2.7%], respectively, P < 0.05).


CONCLUSIONS
The use of LigaSure™ is effective in decreasing operating time, the overall complication rate and postoperative pain.
Nouri
Kazem
K
Department of Gynaecologic Endocrinology and Reproductive Medicine, Medical University of Vienna, Währinger Gürtel 18-20, Vienna, Austria. kazem.nouri@meduniwien.ac.at
Ott
Johannes
J
Demmel
Maurus
M
Promberger
Regina
R
Huber
Johannes C
JC
Mayerhofer
Klaus
K
D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D007045:Hysterectomy, Vaginal / Q000009:adverse effects / Q000379:methods*; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D007902:Length of Stay; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D013536:Suture Techniques / Q000295:instrumentation*; D016896:Treatment Outcome