title: Randomized study comparing use of THUNDERBEAT technology vs standard electrosurgery during laparoscopic radical hysterectomy and pelvic lymphadenectomy for gynecologic cancer.
abstract: OBJECTIVE
  To compare operative time with use of THUNDERBEAT (TB) vs standard electrosurgery (SES) during laparoscopic radical hysterectomy and pelvic lymphadenectomy to treat gynecologic tumors.
  
  
  METHODS
  Evidence obtained from a properly designed, randomized, controlled trial (Canadian Task Force classification I).
  
  
  METHODS
  Gynecologic Oncology Unit of the Catholic University of the Sacred Heart in Rome, Italy.
  
  
  METHODS
  Fifty patients with early cervical cancer (FIGO stages IA2, IB1, IIA <2 cm) or locally advanced cervical cancer (FIGO stages IB2, IIA >2cm, IIB) who received neoadjuvant treatment (chemotherapy or radiochemotherapy) and demonstrated a complete or partial clinical response and early stage endometrioid endometrial cancer (FIGO stages IB, II) were randomly assigned to undergo TB (arm A) or SES (arm B).
  
  
  METHODS
  Laparoscopic radical hysterectomy with bilateral pelvic lymphadenectomy, using an easily reproducible technique was performed.
  
  
  RESULTS
  Fifty patients were available for analysis, with 25 women randomly assigned to TB (arm A) and 25 to SES (arm B). The median operative time was 85 minutes for TB vs 115 minutes for SES (p = .001). At multivariate analysis, endometrial cancer (p = .001) and TB (p = .001) were independently associated with shorter operating time. No differences in perioperative outcomes and postoperative complications were observed between the 2 arms. Patients who underwent TB reported less postoperative pain, both at rest (p = .005) and after the Valsalva maneuver (p = .008), with less additional analgesic therapy other than standard therapy required in patients who underwent SES (p = .02).
  
  
  CONCLUSIONS
  TB is associated with shorter operative time and less postoperative pain than is the standard technique (SES) in patients with uterine cancer.
authors: Department of Minimally Invasive Gynecology, University of Perugia, St. Maria Hospital, Terni, Italy. Electronic address: annafagotti@libero.it.
authors: Anna
authors: A
authors: Fagotti
authors: Department of Gynecologic Oncology, Catholic University of the Sacred Heart, Rome, Italy.
authors: Giuseppe
authors: G
authors: Vizzielli
authors: Institute for Maternal and Child Health, IRCCS "Burlo Garofolo," Trieste, Italy.
authors: Francesco
authors: F
authors: Fanfani
authors: Department of Gynecologic Oncology, Catholic University of the Sacred Heart, Rome, Italy.
authors: Valerio
authors: V
authors: Gallotta
authors: Department of Gynecologic Oncology, Catholic University of the Sacred Heart, Rome, Italy.
authors: Cristiano
authors: C
authors: Rossitto
authors: Department of Gynecologic Oncology, Catholic University of the Sacred Heart, Rome, Italy.
authors: Barbara
authors: B
authors: Costantini
authors: Department of Gynecologic Oncology, Catholic University of the Sacred Heart, Rome, Italy.
authors: Salvatore
authors: S
authors: Gueli-Alletti
authors: Department of Minimally Invasive Gynecology, University of Perugia, St. Maria Hospital, Terni, Italy.
authors: Nicola
authors: N
authors: Avenia
authors: Department of Gynecologic Oncology, Catholic University of the Sacred Heart, Rome, Italy.
authors: Raffaella
authors: R
authors: Iodice
authors: Department of Gynecologic Oncology, Catholic University of the Sacred Heart, Rome, Italy.
authors: Giovanni
authors: G
authors: Scambia
mesh_terms: D000328:Adult; D000368:Aged; D018269:Carcinoma, Endometrioid / Q000601:surgery; D004598:Electrosurgery / Q000295:instrumentation* / Q000706:statistics & numerical data; D016889:Endometrial Neoplasms / Q000601:surgery; D005260:Female; D005833:Genital Neoplasms, Female / Q000601:surgery*; D006801:Humans; D007044:Hysterectomy / Q000295:instrumentation* / Q000379:methods / Q000706:statistics & numerical data; D007558:Italy / Q000453:epidemiology; D010535:Laparoscopy; D008197:Lymph Node Excision / Q000295:instrumentation* / Q000379:methods / Q000706:statistics & numerical data; D008875:Middle Aged; D061646:Operative Time; D010149:Postoperative Pain / Q000453:epidemiology; D002583:Uterine Cervical Neoplasms / Q000601:surgery
keywords: Bipolar; Laparoscopy; Lymphadenectomy; Radical hysterectomy; THUNDERBEAT; Ultrasonic