Comparison of the use of LigaSure, HALO PKS cutting forceps, and ENSEAL tissue sealer in total laparoscopic hysterectomy: a randomized trial.
OBJECTIVE
There are many instruments with different energy modalities or with different properties that are available for use in total laparoscopic hysterectomy. The aim of the study was to compare the use of LigaSure (Valleylab, Boulder, CO), HALO PKS cutting forceps (Gyrus-ACMI, Maple Grove, MA), and ENSEAL tissue sealer (SurgRx, Inc. Redwood City, CA) in total laparoscopic hysterectomy with respect to operation time and blood loss as main outcomes. Perioperative complications, return of gastrointestinal activity, and hospitalization time were assessed as secondary outcomes.


METHODS
Randomized prospective study (Canadian Task Force classification I).


METHODS
Adana Numune Training and Research Hospital.


METHODS
Forty-five patients with the indication of hysterectomy were randomized into 3 groups for total laparoscopic hysterectomy. Patients with malignancies, having 3 or more previous abdominal surgeries, a uterus larger than 12 weeks of gestation, and who had to undergo additional surgical procedures during the same operation were excluded.


METHODS
Total laparoscopic hysterectomy.


RESULTS
Operations were completed in all 15 patients in the LigaSure and HALO PKS Cutting Forceps groups with the planned instruments. In 2 patients in the ENSEAL group, bleeding could not be controlled with ENSEAL, and additional instruments were used. One patient in the ENSEAL group had bladder injury. The mean operation time and blood loss were 52.4 ± 12.8, 51.86 ± 14.11, and 55.7 ± 15.7 minutes (p > .05) and 138 ± 54.3, 118 ± 63.3, and 218 ± 115.9 mL (p < .05) in the LigaSure, HALO PKS, and ENSEAL groups, respectively. Changes in hemoglobin/hematocrit levels, return of gastrointestinal activity, and hospitalization time did not differ between groups.


CONCLUSIONS
These 3 novel bipolar platforms had similar results in total laparoscopic hysterectomy. These instruments were not determined to be independent predictors of operating time and amount of blood loss.
Department of Obstetrics and Gynecology, Mersin University, Mersin, Turkey. Electronic address: drhakanaytan@yahoo.com.
Hakan
H
Aytan
Department of Obstetrics and Gynecology, Adana Numune Training and Research Hospital, Adana, Turkey.
Hakan
H
Nazik
Department of Obstetrics and Gynecology, Adana Numune Training and Research Hospital, Adana, Turkey.
Raziye
R
Narin
Department of Obstetrics and Gynecology, Mersin University, Mersin, Turkey.
Murat
M
Api
Department of Obstetrics and Gynecology, Mersin University, Mersin, Turkey.
Ekrem C
EC
Tok
D000328:Adult; D016063:Blood Loss, Surgical; D004564:Electrocoagulation / Q000295:instrumentation; D004598:Electrosurgery / Q000295:instrumentation; D005260:Female; D006488:Hemostasis, Surgical / Q000295:instrumentation; D006801:Humans; D007044:Hysterectomy / Q000295:instrumentation*; D010535:Laparoscopy / Q000295:instrumentation; D008875:Middle Aged; D061646:Operative Time; D011446:Prospective Studies; D013525:Surgical Instruments; D014591:Uterine Diseases / Q000601:surgery*; D014599:Uterus
ENSEAL; Gyrus; LigaSure; Total laparoscopic hysterectomy