Comparison of the Use of LigaSure,HALO PKS Cutting Forceps,and ENSEAL Tissue Sealer in Total Laparoscopic Hysterectomy: A Randomized Trial |
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| Affiliation: | 1. Department of Obstetrics and Gynecology, Mersin University, Mersin, Turkey;2. Department of Obstetrics and Gynecology, Adana Numune Training and Research Hospital, Adana, Turkey;1. Department of Research and Development, Covidien Surgical Solutions, Boulder, Colorado;2. Department of Biological Engineering, Massachusetts Institute of Technology, Cambridge, Massachusetts;3. Department of Biostatistics and Informatics, University of Colorado Denver, Aurora, Colorado;4. Colorado Clinical and Translational Sciences Institute, University of Colorado Denver, Denver, Colorado;1. University of Montréal, Montreal, Quebec City, Canada;2. Massachusetts General Hospital, Boston, Mass;3. McMaster University, Hamilton, Ontario, Canada;4. Jefferson University, Philadelphia, Pa;5. University of Toronto, Toronto, Ontario, Canada;6. McGill University, Montreal, Quebec City, Canada;1. Department of Obstetrics and Gynecology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand;2. Department of Anaesthesiology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand |
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| Abstract: | Study ObjectiveThere are many instruments with different energy modalities or with different properties that are available for use in total laparoscopic hysterectomy. The aim of the study was to compare the use of LigaSure (Valleylab, Boulder, CO), HALO PKS cutting forceps (Gyrus-ACMI, Maple Grove, MA), and ENSEAL tissue sealer (SurgRx, Inc. Redwood City, CA) in total laparoscopic hysterectomy with respect to operation time and blood loss as main outcomes. Perioperative complications, return of gastrointestinal activity, and hospitalization time were assessed as secondary outcomes.DesignRandomized prospective study (Canadian Task Force classification I).SettingAdana Numune Training and Research Hospital.PatientsForty-five patients with the indication of hysterectomy were randomized into 3 groups for total laparoscopic hysterectomy. Patients with malignancies, having 3 or more previous abdominal surgeries, a uterus larger than 12 weeks of gestation, and who had to undergo additional surgical procedures during the same operation were excluded.InterventionsTotal laparoscopic hysterectomy.Measurements and Main ResultsOperations were completed in all 15 patients in the LigaSure and HALO PKS Cutting Forceps groups with the planned instruments. In 2 patients in the ENSEAL group, bleeding could not be controlled with ENSEAL, and additional instruments were used. One patient in the ENSEAL group had bladder injury. The mean operation time and blood loss were 52.4 ± 12.8, 51.86 ± 14.11, and 55.7 ± 15.7 minutes (p > .05) and 138 ± 54.3, 118 ± 63.3, and 218 ± 115.9 mL (p < .05) in the LigaSure, HALO PKS, and ENSEAL groups, respectively. Changes in hemoglobin/hematocrit levels, return of gastrointestinal activity, and hospitalization time did not differ between groups.ConclusionThese 3 novel bipolar platforms had similar results in total laparoscopic hysterectomy. These instruments were not determined to be independent predictors of operating time and amount of blood loss. |
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| Keywords: | ENSEAL Gyrus LigaSure Total laparoscopic hysterectomy |
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