Comparison of the ultrasonic scalpel to CO₂laser in cervical conization

Abstract

The aim of the present study was to compare the efficacy of CO(2) laser with that of ultrasonic scalpel in cervical conization in terms of intraoperative and postoperative outcome. One-hundred and two patients were submitted to cervical conization by ultrasonically activated scalpel, while 97 patients were submitted to cervical conization by use of CO(2) laser. Comparison of mean estimated blood loss, mean operative time and mean cone volume between the two groups was performed with Student t test. Postoperative complications were compared by x(2) test. There was no statistical significance regarding the mean operating time, mean blood loss, mean cone volume and postoperative complications in the two methods. However, thermal artifacts at the cone margins were minimal in the harmonic group (2/102 cones, 1.96%), while in the laser group they were considerably more (18/97 cones, 18.5%) (p < 0.05). Conization using the harmonic scalpel is as safe and effective as the CO(2) laser procedure. It is cheaper, produces less smoke, better visual field and less thermal artifacts in the cone margins. It is a reliable method that overcomes most problems associated with the CO(2) laser, as well as the other conventional conization procedures.

The effects of different instruments and suture methods of conization for cervical lesions

“…Currently, in China, cold knife conization (CKC) is used as a primary choice. Alternative methods, such as electrosurgical conization (ESC) 4 , laser conization 5 , harmonic scalpel 6 , and the loop electrosurgical excision procedure (LEEP) 7 , were subsequently developed and attempted. Between different treatment regimens, there was very low quality evidence for the comparison of important parameters, including reproductive outcomes and complications 8 , in particular for screen-and-treat strategies relevant to low- and middle-income countries 9 .…”