Perioperative outcomes of bipolar energy instruments in total laparoscopic hysterectomy

Yalçın, Yakup; Yalçın, Serenat Eriş

doi:10.5603/gp.2019.0112

Cited by 1 publication

(1 citation statement)

References 20 publications

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“…Several devices are available on the market with different designs, mechanical systems, or tissue-impedance monitoring technologies, but all have similar performance and are approved for sealing vessels up to 7 mm in diameter [ 9 ]. In the last years, the use of ABVS devices and their research interest significantly increased in all surgical specialties [ 10 ], and the advantages, as mentioned above, seemed to balance or overcome the high costs [ 11 , 12 ].…”

Section: Introductionmentioning

confidence: 99%

Advanced bipolar vessel sealing devices vs conventional bipolar energy in minimally invasive hysterectomy: a systematic review and meta-analysis

Zorzato,

Ferrari,

Garzon

et al. 2023

Arch Gynecol Obstet

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Purpose To compare conventional bipolar electrosurgery with advanced bipolar vessel sealing (ABVS) devices for total laparoscopic hysterectomy (TLH). Methods A systematic review was conducted by searching Scopus, PubMed/MEDLINE, ScienceDirect, and Cochrane Library from January 1989 to November 2021. We identified all studies comparing ABVS devices with conventional bipolar electrosurgery in TLH and reporting at least one of the following outcomes: total blood loss, total operative time, hospital stay, perioperative complications, or costs. Meta-analysis was conducted with a random effect model reporting pooled mean differences and odds ratios (ORs) with related 95% confidence intervals (CIs). Results Two randomized controlled trials and two retrospective studies encompassing 314 patients were included out of 615 manuscripts. The pooled estimated total blood loss in the ABVS devices group was lower than conventional bipolar electrosurgery of 39 mL (95% CI − 65.8 to − 12.6 mL; p = .004). The use of ABVS devices significantly reduced the total operative time by 8 min (95% CI − 16.7 to − 0.8 min; p = .033). Hospital stay length did not differ between the two groups, and a comparable overall surgical complication rate was observed [OR of 0.9 (95% CI 0.256 – 3.200; p = .878]. Conclusions High-quality evidence comparing ABVS devices with conventional bipolar electrosurgery for TLH is lacking. ABVS devices were associated with reduced total blood loss and operative time; however, observed differences seem clinically irrelevant. Further research is required to clarify the advantages of ABVS devices over conventional bipolar electrosurgery and to identify cases that may benefit more from their use.

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