DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20175286

Comparative evaluation of abdominal hysterectomy by ligasure and conventional method

Harjinder Singh, Monika Jindal, Monika Gupta, S. P. S. Goraya, Manisha Behal, Tanjeet .

Abstract


Background: Hysterectomy is the 2nd most common surgical procedure performed in women and is associated with various complications like any other major surgical procedure. The objectives and aims of this study was to compare the effects of ligasure and conventional clamping and suturing in abdominal hysterectomy.

Methods: A randomized controlled trial was performed by randomizing the patients in 2 groups - ligasure (A) and conventional hysterectomy (B). Operative time, no. of sutures, blood loss, hospital stay and cost factor to patient were studied as its main outcomes. A total of 100 patients were studied.

Results: 66% of patients in group A had duration of surgery that was less than an hour in spite of associated co-morbidities. More no (76%) of patients in Group A had significantly less blood loss (<50 ml) as compared to 60% of patients in Group B. Only one suture was used in 80% of patients in Group A while in group B all of the patients required more than one suture from stumps to vault. There by reducing the cost of surgery.

Conclusion: Apparently ligasure group seems to have less time for surgery and less blood loss and more intraoperative and postoperative complications, but to prove one ligasure group superior or inferior over conventional method we need to have more studies. But yes, Ligasure group reduces the cost of surgery to patient by reducing suture consumption as compared to conventional group.

 


Keywords


Blood loss, Conventional, Ligasure, Hysterectomy, Suture

Full Text:

PDF

References


Wu JM, Wechter ME, Geller EJ, Nguyen TV, Visco AG. Hysterectomy rates in the United States, 2003. Obstet Gynecol. 2007;110(5):1091-5.

Singh A, Arora AK. Why hysterectomy rate is lower in India. Indian J Community Med. 2008 ;33(3):196.

Desai S, Sinha T, Mahal A. Prevalence of hysterectomy among rural and urban women with and without health insurance in Gujarat, India. Reproductive Health Matters. 2011;19(37):42-51.

Pandey D, Sehgal K, Saxena A, Hebbar S, Nambiar J, Bhat RG. An audit of indications, complications, and justification of hysterectomies at a teaching hospital in India. Int J Reprod Med. 2014;2014.

Hefni MA, Bhaumik J, El‐Toukhy T, Kho P, Wong I, Abdel‐Razik T, et al. Safety and efficacy of using the LigaSure vessel sealing system for securing the pedicles in vaginal hysterectomy: randomised controlled trial. Int J Obstet Gynaecol. 2005;112(3):329-33.

Zubke W, Hornung R, Wässerer S, Hucke J, Füllers U, Werner C, et al. Bipolar coagulation with the BiClamp® forceps versus conventional suture ligation: a multicenter randomized controlled trial in 175 vaginal hysterectomy patients. Arch Gynecol Obstet. 2009;280(5):753-60.

Lee NC, Dicker RC, Rubin GL, Ory HW. Confirmation of the preoperative diagnoses for hysterectomy. Am J Obstet Gynecol. 1984;150(3):283-7.

McPherson K, Herbert A, Judge A, Clarke A, Bridgman S, Maresh M, et al. Psychosexual health 5 years after hysterectomy: population‐based comparison with endometrial ablation for dysfunctional uterine bleeding. Health Expectations. 2005;8(3):234-43.

Farquhar CM, Sadler L, Harvey SA, Stewart AW. The association of hysterectomy and menopause: a prospective cohort study. Int J Obstet Gynaecol. 2005;112(7):956-62.

Gizzo S, Burul G, Di Gangi S, Lamparelli L, Saccardi C, Nardelli GB, et al. LigaSure vessel sealing system in vaginal hysterectomy: safety, efficacy and limitations. Arch Gynecold Obstet. 2013;288(5):1067-74.

Janssen PF, Brölmann HA, van Kesteren PJ, Bongers MY, Thurkow AL, Heymans MW, et al. Perioperative outcomes using LigaSure™ compared to conventional bipolar instruments in laparoscopic salpingo-oophorectomy: a randomized controlled trial. Surgical Endoscopy. 2012;26(10):2884-91.

Ding Z, Wable M, Rane A. Use of LigaSure™ bipolar diathermy system in vaginal hysterectomy. J Obstet Gynaecol. 2005;25(1):49-51.

Hagen B, Eriksson N, Sundset M. Randomised controlled trial of LigaSure versus conventional suture ligature for abdominal hysterectomy. Int J Obstet Gynaecol. 2005;112(7):968-70.

Levy B, Emery L. Randomized trial of suture versus electrosurgical bipolar vessel sealing in vaginal hysterectomy. Obstet Gynecol. 2003;102(1):147-51.

Lakeman M, Kruitwagen RF, Vos MC, Roovers JP. Electrosurgical bipolar vessel sealing versus conventional clamping and suturing for total abdominal hysterectomy: a randomized trial. J Minimally Invasive Gynecol. 2008;15(5):547-53.