Objectives: To evaluate whether the use of barbed sutures during laparoscopic hysterectomy for vaginal cuff closure has reduced the surgical difficulty and incidence of post-operative complications as compared to polyglactin 910 suture. Materials and Methods: This is a randomized comparative study conducted at a tertiary care hospital and research institute where 100 patients were divided into two groups (50 each) and underwent vault closure using barbed suture/Polyglactin 910. Data collected include demographic details, indication for surgery, mean suturing time, degree of surgeon difficulty, and the incidence of postoperative complications when followed up to 12 weeks and were compared statistically using Chi square test and Independent-t test. Results: The use of barbed suture has significantly reduced the suturing time (5.39 min vs. 6.9 min, P < 0.0001) and surgical difficulty. The incidence of minor complications is similar to that of polyglactin 910. There were no cases of vaginal cuff dehiscence or bowel obstruction reported in our study. Conclusion: With the advantages of reduced suturing time and technical difficulty, and incidence of complications similar to conventional suture material, barbed sutures are to be considered as an excellent alternative to conventional suture materials.
Context: Hysterectomy is the most commonly performed gynecological procedure around the world. Hemostasis is of major concern in an enlarged uterus as chances of hemorrhage are more. New laparoscopic vessel sealing devices have been developed for laparoscopic tissue dissection and vessel sealing. In this study, an ALAN vessel sealer, an indigenous electrothermal bipolar vessel sealing device, is compared with ENSEAL device with respect to safety, efficacy, and perioperative outcomes in laparoscopic hysterectomy for a large uterus. Aims and objectives: This study aimed to determine the efficacy and safety of electrothermal bipolar vessel sealer (ALAN vessel sealer) vs ENSEAL in total laparoscopic hysterectomy (TLH) for a large uterus. Materials and methods: This prospective randomized case-control study included 100 women who underwent TLH for a large fibroid uterus. Of them, 50 women underwent TLH using ALAN vessel sealer, and the remaining 50 using ENSEAL. Efficacy, safety, and perioperative outcomes of both the groups were compared. Statistical analysis: Statistical analysis was done using SPSS version 16.0 software. For evaluating continuous variables and discrete variables, independent T-tests, and Chi-square tests, respectively, were used. Results: Duration of surgery in ALAN vessel sealer group was 56.90 ± 12.45 minutes and in ENSEAL group was 57.25 ± 13.54 minutes (p = 0.9) and mean blood loss in group A and group B was 111.40 ± 22.32 and 107.84 ± 20.33 mL, respectively ( p = 0.4), both of the data were not statistically significant. No significant differences were noticed in the demographic characteristics, intraoperative, and postoperative complications between the two groups. Conclusions: The ALAN vessel sealer is safe and as efficient as ENSEAL in decreasing blood loss and operative time when laparoscopic hysterectomy is performed for an enlarged uterus. It is cost-effective and a promising instrument for TLH in developing countries.
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