Vaginal hysterectomy and multimodal anaesthesia with bipolar vessel sailing (Biclamp® forceps) versus conventional suture technique: quality results’ analysis

Leo, Livio; Riboni, Francesca; Gambaro, Carlo; Surico, Daniela; Surico, N

doi:10.1007/s00404-011-2093-5

Cited by 8 publications

(11 citation statements)

References 16 publications

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“…L'utilisation de la thermofusion a prouvé son bénéfice sur les sutures classiques dans les hystérectomies en terme de diminution des saignements [46,47] et de réduction du temps opératoire [46,48,49]. L'utilisation de la thermofusion a aussi permis de diminuer de façon significative la durée du séjour hospitalier après hystérectomie vaginale et annexectomie bilatérale [50] mais aussi après hystérectomie par laparotomie [51]. Devant un désir de prise en charge en ambulatoire, ces outils semblent indispensables puisqu'ils permettent de diminuer le temps opératoire, les saignements peropératoires et les douleurs postopératoires [52,53].…”

Section: Critères Post-opératoiresunclassified

Critères d’acceptabilité et de faisabilité de l’hystérectomie en ambulatoire, enquête auprès de 152 chirurgiens

Foulon

Dolivet

Chevreau

et al. 2020

Gynécologie Obstétrique Fertilité & Sénologie

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Section: Critères Post-opératoiresunclassified

Critères d’acceptabilité et de faisabilité de l’hystérectomie en ambulatoire, enquête auprès de 152 chirurgiens

Foulon

Dolivet

Chevreau

et al. 2020

Gynécologie Obstétrique Fertilité & Sénologie

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“…Of these, 39 were excluded because they did not meet eligibility criteria. Thus, 116 studies were included in the final analysis, 11,23–137 including 15 RCTs, 17 nonrandomized comparative studies, and 84 single-group studies (Fig. 1).…”

Section: Resultsmentioning

confidence: 99%

Enabling Technologies for Gynecologic Vaginal Surgery

Balgobin,

Balk,

Porter

et al. 2024

Obstetrics &Amp; Gynecology

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OBJECTIVE: To systematically review the literature to evaluate clinical and surgical outcomes for technologies that facilitate vaginal surgical procedures. DATA SOURCES: We systematically searched MEDLINE, EMBASE, and ClinicalTrials.gov from January 1990 to May 2022. METHODS OF STUDY SELECTION: Comparative and single-arm studies with data on contemporary tools or technologies facilitating intraoperative performance of vaginal gynecologic surgical procedures for benign indications were included. Citations were independently double screened, and eligible full-text articles were extracted by two reviewers. Data collected included study characteristics, technology, patient demographics, and intraoperative and postoperative outcomes. Risk of bias for comparative studies was assessed using established methods, and restricted maximum likelihood model meta-analyses were conducted as indicated. TABULATION, INTEGRATION, AND RESULTS: The search yielded 8,658 abstracts, with 116 eligible studies that evaluated pedicle sealing devices (n=32), nonrobotic and robotic vaginal natural orifice transluminal endoscopic surgery (n=64), suture capture devices (n=17), loop ligatures (n=2), and table-mounted telescopic cameras (n=1). Based on 19 comparative studies, pedicle sealing devices lowered vaginal hysterectomy operative time by 15.9 minutes (95% CI, −23.3 to −85), blood loss by 36.9 mL (95% CI, −56.9 to −17.0), hospital stay by 0.2 days (95% CI, −0.4 to −0.1), and visual analog scale pain scores by 1.4 points on a subjective 10-point scale (95% CI, −1.7 to −1.1). Three nonrandomized comparative studies and 53 single-arm studies supported the feasibility of nonrobotic vaginal natural orifice transluminal endoscopic surgery for hysterectomy, adnexal surgery, pelvic reconstruction, and myomectomy. Data were limited for robotic vaginal natural orifice transluminal endoscopic surgery, suture capture devices, loop ligatures, and table-mounted cameras due to few studies or study heterogeneity. CONCLUSION: Pedicle sealing devices lower operative time and blood loss for vaginal hysterectomy, with modest reductions in hospital stay and pain scores. Although other technologies identified in the literature may have potential to facilitate vaginal surgical procedures and improve outcomes, additional comparative effectiveness research is needed. SYSTEMATIC REVIEW REGISTRATION: PROSPERO, CRD42022327490.

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“…Fifteen studies examined the use of a tissue sealing, stapling, or suturing device compared with traditional clamping and suture ligation during vagi-nal hysterectomy (n51,389). The number of study participants per trial ranged from 10 36 to 200, 37 and study qualities were good, [38][39][40][41][42][43] fair, 44,45 and 12,13,16,18 Bilateral salpingooophorectomy 1 Insufficient evidence is available to comment on factors associated with successful completion of BSO 59 Peritoneal closure 5 Five studies evaluated peritoneal closure (n5363) with fair [60][61][62][63] and poor 64 study quality; three studies compared only closing peritoneum with only closing vaginal epithelium (n5207) 60,62,64 ; overall, no difference was seen in complications between groups with the exception of one study that intentionally left a small portion of the peritoneum open to drain, which reported one fallopian tube prolapse and one bowel evisceration 62 ; all of these studies were underpowered for both their primary and secondary outcomes; there is insufficient evidence to recommend for or against adding peritoneal closure when closing the vaginal cuff Tissue sealers 2 One study evaluated the Multifire Endo-GIA stapler compared with traditional suture ligation (n510) 46 ; another study compared an aneurysm needle suture technique with traditional suturing (n546) 37 ; based on the limited data regarding these techniques, reliable conclusions cannot be made…”

Section: Postoperativementioning

confidence: 99%

“…36,37,[46][47][48][49][50] Eight studies evaluated the Ligasure, 36,[38][39][40]43,44,48,50 and four examined other similar bipolar clamps. 42,45,47,49 One study evaluated ultrasonic shears compared with traditional suture ligation (n543). 41 Narcotic analgesia use, length of hospital stay, hysterectomy time, and total operative time were similar in both groups (high strength of evidence).…”

Section: Bladder Functionmentioning

confidence: 99%

Comparison of Vaginal Hysterectomy Techniques and Interventions for Benign Indications: A Systematic Review

Jeppson

Balgobin

Rahn

et al. 2017

Obstetrical &Amp; Gynecological Survey

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for the Society of Gynecologic Surgeons Systematic Review Group OBJECTIVE: To create evidence-based clinical practice guidelines based on a systematic review of published literature regarding the risks and benefits of available preoperative, intraoperative, and postoperative technical steps and interventions at the time of vaginal hysterectomy for benign indications. DATA SOURCES:We systematically searched the literature to identify studies that compared technical steps or interventions during the preoperative, intraoperative, and postoperative periods surrounding vaginal hysterectomy. We searched MEDLINE, Cochrane Central Register of Controlled Trials, Health Technology Assessments, and ClinicalTrials.gov from their inception until April 10, 2016, using the MeSH term "Hysterectomy, Vaginal" and associated text words. We included comparative studies, singlegroup studies, and systematic reviews published in English. METHODS OF STUDY SELECTION:We doublescreened 4,250 abstracts, identifying 60 eligible studies. Discrepancies were adjudicated by a third reviewer. We followed standard systematic review methodology and the Grades for Recommendation, Assessment, Development and Evaluation approach to evaluate the evidence and generate guideline recommendations. TABULATION, INTEGRATION, AND RESULTS:Because of limited literature, only 16 perioperative risks, technical steps, and interventions were identified: obesity, large uteri, prior surgery, gonadotropin-releasing hormone agonists, vaginal antisepsis, bilateral salpingooophorectomy, morcellation, apical closure, uterine sealers, hemostatic injectants, hot cone, retractor, cystoscopy, vaginal packing, bladder management, and accustimulation. We organized and reported these as four domains: patient selection, preoperative, intraoperative, and postoperative. We did not identify any patient characteristics precluding a vaginal approach; chlorhexidine or povidone is appropriate for vaginal antisepsis; vasopressin decreases blood loss by 130 cc; tissue-sealing devices decrease blood loss by 44 cc and operative time by 15 minutes with uncertain complication implications; vertical cuff closure results in 1-cm increased vaginal length; either peritoneum or epithelium can be used for colpotomy closure; and routine vaginal packing is not advised.CONCLUSION: Minimal data exist to guide surgeons with respect to planning and performing a vaginal hysterectomy. This study identifies available information and future areas for investigation.

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Vaginal hysterectomy and multimodal anaesthesia with bipolar vessel sailing (Biclamp® forceps) versus conventional suture technique: quality results’ analysis

Cited by 8 publications

References 16 publications

Critères d’acceptabilité et de faisabilité de l’hystérectomie en ambulatoire, enquête auprès de 152 chirurgiens

Critères d’acceptabilité et de faisabilité de l’hystérectomie en ambulatoire, enquête auprès de 152 chirurgiens

Enabling Technologies for Gynecologic Vaginal Surgery

Comparison of Vaginal Hysterectomy Techniques and Interventions for Benign Indications: A Systematic Review

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