Bipolar coagulation with the BiClamp® forceps versus conventional suture ligation: a multicenter randomized controlled trial in 175 vaginal hysterectomy patients

Zubke, W.; Hornung, René; Wässerer, Sabine; Hucke, J.; Füllers, U.; Werner, Christoph; Schmitz, Peter; Lobodasch, Kurt; Hammermüller, Uwe; Wojdat, R.; Volz, Joachim; Wilde, Rudy Leon De; Wallwiener, D.

doi:10.1007/s00404-009-1010-7

Cited by 33 publications

(44 citation statements)

References 19 publications

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“…Bogani et al pointed out that the patient BMI is directly proportional to the rate of complications due to hysterectomy. The higher intraoperative complication rates in our study and control groups compared with those reported in previously published studies could be explained by these factors [9,12,[14][15][16][17].…”

Section: Discussionsupporting

confidence: 50%

“…Accordingly, a few authors suggested the use of advanced electrosurgical instruments that provide the ability to rapidly and sequentially seal vessels and coagulate and transect pedicles with a tool manipulated by one hand. Previous studies showed such instruments adapted to vaginal surgery from laparoscopic practice were suitable alternatives to conventional suturing techniques and had similar safety profiles [7,12,13]. To our knowledge, no studies have yet compared the surgery-related outcomes of EBVS system and conventional suture ligation technique only focusing on the morbidly obese patients undergoing VH.…”

Section: Discussionmentioning

confidence: 99%

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Safety and efficacy of using advanced electrosurgical bipolar vessel sealing during vaginal hysterectomy in morbidly obese patients: a retrospective cohort analysis

et al. 2017

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Objectives: To assess the safety and efficacy of electrosurgical bipolar vessel sealing during vaginal hysterectomy in morbidly obese patients. Material and methods:A total of 105 morbidly obese patients who underwent vaginal hysterectomy due to benign gynecologic pathologies between January 2010 and April 2017 were included in the study. Patients were divided into two groups according to whether conventional suture ligation technique (n = 64) or electrosurgical bipolar vessel sealing (n = 41) were used during vaginal hysterectomy. The surgical procedure was performed with the same technique in both study groups. The primary outcomes were duration of surgery and estimated blood loss. The secondary outcomes were intra-operative complications and post-operative complications. Results:The duration of surgery and estimated blood loss in the vessel sealing group was significantly less than in the conventional suture group (p < 0.05). No significant difference was present between the two groups in the rate of intra-operative and post-operative complications. Conclusions:The primary outcome of our study is that the EBVS system can be used equally and even more effectively in some aspects; and as safe an alternative approach to conventional suture ligation technique during vaginal hysterectomies performed specifically on morbidly obese patients with reduced operation times and blood loss, and without increasing the complication rates.

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Section: Discussionsupporting

confidence: 50%

Section: Discussionmentioning

confidence: 99%

Safety and efficacy of using advanced electrosurgical bipolar vessel sealing during vaginal hysterectomy in morbidly obese patients: a retrospective cohort analysis

et al. 2017

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“…A significant reduction in hospital stay was also seen by Clave et al (6 days v/s1 day), Ding et al (1.2 vs 3 days), Lewy et al (1 vs 3 days) and Zubke et al (6.6 vs 7.4 days). 16,18,20,23 Cronje and de Coning did not find a significant difference. 19 We conducted present study on a mixed group of patients with various indications, with different surgical difficulties in different groups.…”

Section: Discussionmentioning

confidence: 76%

“…16,21,22 Relatively more number of women had blood loss >100 ml in suture group i.e. 34 out of 86 versus 9 out of 88 patients in the sealer group in the study by Zubke et al 20 Even though most studies noted this difference in blood loss, studies of Hefni et al and Cronje and de Coning did not find any significant difference in blood loss between the two group of patients. 17,19 We evaluated post-operative pain on Visual Analogue Scale on a score of 1-10.…”

Section: Discussionmentioning

confidence: 86%

“…12,19 Zubke et al noted a significant reduction in post-operative pain medication. 20 Lakeman et al, however, found that the post-operative pain was significantly different only on the evening after surgery, while, the pain scores and the return to normal activities in the two groups from the next day onwards. 15 Major intra-operative complications were noted in the forms of bladder perforation, major blood loss>200ml and labial burn.…”

Section: Discussionmentioning

confidence: 90%

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Suture versus vessel sealer in vaginal hysterectomy: an observational study

Upadhyay

Aditya

Gupta

et al. 2017

Int J Reprod Contracept Obstet Gynecol

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Background: Vaginal route is considered to be the method of choice for removal of uterus and, in the absence of gross pelvic disease, can be carried out in most patients. Recent studies have shown that less than one-third of hysterectomies are performed vaginally. This could be due to technical difficulties occurring while operating in the narrow surgical field. This study was taken up to find out the easier alternatives in securing pedicles by using Electrosurgical Bipolar Vessel Sealer in Vaginal Hysterectomy.Methods: A prospective observational study was conducted in the Department of Obstetrics and Gynaecology, BRD Medical College, Gorakhpur over a period of one year i.e. July 15 to June 16. A total of 62 patients posted for vaginal hysterectomy for benign conditions were enrolled after informed consent. Results were recorded under headings of procedure time (min), blood loss (ml), major intra-operative complications and post operative complications, post-operative pain (on VAS) and duration of hospital stay.Results: Mean procedure time in suture method was found to be 55.66min, whereas, in sealer group it was 27.75 min. Mean blood loss in the sealer group was 83.78ml, while, in suture group it was 156.62ml. Mean pain score on Visual Analogue Scale on POD 1 was 8.44±1.1522 for suture group and 6±1.325 for sealer group. Mean pain score on POD2 in sealer group was 3.48±1.325 and in the suture group it was 5.31±1.754 (P<0.0001). Mean pain score on POD3 in suture group 2.82±0.508, in sealer group it was 1.0909±0.608 (P<0.0001). Pain scores, thereafter, did not differ significantly. Mean length of stay in suture group is 10.71 days (suture group) versus 5.3 days (sealer group). Blood loss >200ml was observed in 29.03% of suture cases, none in the sealer group (P-value .0006). Labial burn occurred in 2 out of 32patients in sealer group.Conclusions: From above study, we conclude that bipolar vessel sealer has shown a significant reduction in intra-operative blood loss, procedure time, immediate post-operative pain (POD1,2&3), mean length of stay in hospital, major intra-operative blood loss>200ml which was found in significant number of cases in suture group.

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Randomized clinical trial of BiClamp forceps versus clamp-crushing technique in open liver resection

Chen

Geng

Zhang

et al. 2017

J Hepatobiliary Pancreat Sci

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Bipolar coagulation with the BiClamp® forceps versus conventional suture ligation: a multicenter randomized controlled trial in 175 vaginal hysterectomy patients

Cited by 33 publications

References 19 publications

Safety and efficacy of using advanced electrosurgical bipolar vessel sealing during vaginal hysterectomy in morbidly obese patients: a retrospective cohort analysis

Safety and efficacy of using advanced electrosurgical bipolar vessel sealing during vaginal hysterectomy in morbidly obese patients: a retrospective cohort analysis

Suture versus vessel sealer in vaginal hysterectomy: an observational study

Randomized clinical trial of BiClamp forceps versus clamp-crushing technique in open liver resection

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