title: Comparison of ultrasonic shears and traditional suture ligature for vaginal hysterectomy: randomized controlled trial.
abstract: OBJECTIVE
  To compare operating time, intraoperative blood loss, postoperative analgesia, and length of hospital stay using ultrasonic shears vs traditional suture ligature in vaginal hysterectomy.
  
  
  METHODS
  Randomized controlled trial (Canadian Task Force classification I).
  
  
  METHODS
  Gynecology units within a single health network, university hospital.
  
  
  METHODS
  Forty women requiring vaginal hysterectomy because of benign disease.
  
  
  METHODS
  Vaginal hysterectomy performed using either ultrasonically activated shears (USS) or traditional suture ligatures.
  
  
  RESULTS
  Twenty-one patients were randomized to the USS arm, and 19 patients to the traditional suture ligature arm. Patient characteristics were comparable. Mean (SD) hysterectomy time and was similar in both the USS and traditional arms, 28.66 (4.0) minutes vs 32.37 (3.18) minutes (p = .47), as was total operating time, 97.38 (8.9) minutes vs 91.63 (7.69) minutes (p = .63). Operative blood loss was significantly decreased in the USS group: 62.63 (12.46) mL vs 136.05 (21.54) mL (p = .006). There was, however, no significant change in hemoglobin concentration between the 2 groups: 19.53 (1.79) g/L vs -16.72 (2.5) g/L. There was no significant difference in mean oxycodone use: 9.29 (2.66) mg vs 8.06 (3.19) mg (p = .77). Length of hospital stay was similar in both groups: 58.98 (3.27) hours vs 60.05 (6.48) hours (p = .88). There was no significant difference in overall complication rates between the groups.
  
  
  CONCLUSIONS
  Although the Harmonic scalpel system, compared with the traditional suture ligation method, seems to be a safe alternative for securing the pedicles in vaginal hysterectomy, it offers no benefit insofar as operative time, reduction in clinically significant blood loss, and analgesic requirements.
authors.affiliation: Monash Medical Center/Southern Health ClaytonAustralia. Electronic address: fitzali@gmail.com.
authors.forename: Alison Louise
authors.initials: AL
authors.lastname: Fitz-Gerald
authors.forename: Jason
authors.initials: J
authors.lastname: Tan
authors.forename: Kok-Weng
authors.initials: KW
authors.lastname: Chan
authors.forename: Alex
authors.initials: A
authors.lastname: Polyakov
authors.forename: Geoff N
authors.initials: GN
authors.lastname: Edwards
authors.forename: Haider
authors.initials: H
authors.lastname: Najjar
authors.forename: Jim
authors.initials: J
authors.lastname: Tsaltas
authors.forename: Beverley
authors.initials: B
authors.lastname: Vollenhoven
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007045:Hysterectomy, Vaginal / Q000379:methods*; D008026:Ligation / Q000379:methods*; D008875:Middle Aged; D013536:Suture Techniques; D013537:Sutures; D016896:Treatment Outcome
keywords: Ultrasonic shears; Vaginal hysterectomy