Perioperative outcomes using LigaSure compared with conventional bipolar instruments in laparoscopic hysterectomy: a randomised controlled trial

Abstract

Objective To compare the effects of LigaSure versus the conventional bipolar technique on operating time and blood loss during laparoscopic hysterectomy.Design A randomised controlled trial.Setting Three teaching hospitals.Population Women undergoing a laparoscopic hysterectomy for benign indications.Methods 140 women undergoing a laparoscopic hysterectomy were randomised for LigaSure or conventional bipolar instruments.Main outcome measures Primary outcome was operating time from initial skin incision till detachment of the uterus. Secondary outcome measures were total operating time (from initial skin incision till final skin closure), time to dissect the adnexal ligaments, intra-operative blood loss and subjective evaluation by the surgeon of the instrument used.Results No differences in operating time (from initial skin incision till uterine detachment and initial skin incision till final skin closure) using LigaSure versus conventional bipolar instruments: 97.6 versus 91.8 minutes (P = 0.39, 95% CI -7.6 to 19.2), and 148.1 versus 142.1 minutes (P = 0.46, 95% CI -10.1 to 22.3), respectively. The mean blood loss using LigaSure versus conventional bipolar was 234.1 versus 273.1 ml (P = 0.46, 95% CI -39.1 to 52.7). Various subjective efficacy and instrument handling parameters were significantly different between the two instruments and between the different participating centres.Conclusions There were no significant differences in operating time and blood loss between the use of LigaSure and the use of conventional bipolar instruments during laparoscopic hysterectomy, even after correction for potential confounders. User satisfaction parameters were assessed as significantly different by surgeons of the participating centres.

Neurologic injury and patient displacement in gynecologic laparoscopic surgery using a beanbag and shoulder supports

“…However, more than 97% of the notes were generated electronically, which decreases loss of data owing to illegibility of handwritten notes, and the notes included questions evaluating preoperative and postoperative extremity symptoms. It is also reassuring that the rate of other complications is similar to the rates reported in prospective studies (randomized trials) of gynecologic laparoscopic surgery . The description of complications is strengthened by our use of the Clavien–Dindo classification…”

“…It is also reassuring that the rate of other complications is similar to the rates reported in prospective studies (randomized trials) of gynecologic laparoscopic surgery. [5][6][7][8] The description of complications is strengthened by our use of the Clavien-Dindo classification. 4…”

Total laparoscopic hysterectomy, vaginal hysterectomy and total abdominal hysterectomy using electrosurgical bipolar vessel sealing technique: a randomized controlled trial

“…McCareken et al [11] reported more blood loss in VH group compared to AH and laparoscopic-assisted VH (LAVH) in their study. Janssen et al [12] found that the blood loss was lower in TLH using EBVS as compared to conventional bipolar TLH.…”

Perioperative outcomes using LigaSure™ compared to conventional bipolar instruments in laparoscopic salpingo-oophorectomy: a randomized controlled trial

“…The reduction in blood loss with the LigaSure in those studies may be explained by the less effective hemostasis in large vessels by ultrasonic devices [25][26][27]. One other study that compared LigaSure with conventional bipolar instruments in a random way in laparoscopic hysterectomy was also not able to detect any significant differences with respect to operating time or blood loss [28].…”