Abstract
Aim: The aim of this study was to compare the use of Electrothermal Bipolar Vessel Sealer (EBVS) with Harmonic Scalpel (HS) during laparoscopic supracervical hysterectomy (LSH) with respect to operation time, estimated blood loss and related complications. Methods: A randomized clinical study was conducted in the OB/GYN Department, Maternity Hospital, Kuwait, from March 2009 till January 2011. Forty candidates for Laparoscopic Supracervical Hysterectomy were enrolled and divided randomly into two equal groups of 20 patients each. Twenty hysterectomies (LSH) were performed using the Harmonic Shears (HS) (group I) and the other twenty patients (group II) had LSH operation using Electro-Thermal Blood Vessel Sealer (EBVS) technology. All the operations were performed by the same surgeon. Data about the characteristics of the patients, operation time, estimated blood loss, related complications and length of hospital stay were registered and compared. Results: Mean operation time, Hemoglobin (Hb) and Hematocrite value (Ht) drop, and hospital stay were significantly less in the bipolar vessel sealer group. There was significant reduction in operation time using the EBVS technique (64.15 ± 12.02) minutes as compared to HS technique (138.25 ± 23.41) minutes. Blood loss during operation was significantly lower in group (II) patients compared to group (I) demonstrated by significant greater drop in hemoglobin and hematocrite in the latter compared to the former group. The mean Hemoglobin drop in group (I) patients was (3.15 ± 0.82) while hematocrite drop was (3.72 ± 0.74). The mean hemoglobin drop for group (II) patients was (0.43 ± 0.33), while hematocrite drop was (0.74 ± 0.41). The mean hospital stay time for group (I) patients was 2.0 ± 1.52 days. The mean hospital stay for group (II) was 1.65 ± 0.58 days; the difference was not statistically significant. Conclusion: The bipolar vessel sealer technique seems to be less time-consuming during operation and caused less bleeding when compared with harmonic shears. Further studies with larger number of patients are required for stronger evaluation of the technique.
Highlights
Hysterectomy is one of the commonest gynecologic surgical procedures practiced in the United States [1]
Laparoscopic Supracervical Hysterectomy (LSH) is a type of hysterectomy that allows the woman to retain her cervix while taking out the part of the uterus that causes the painful periods and heavy vaginal bleeding
Many other studies have shown no difference in sexual function between groups of women undergoing hysterectomy with removal of their cervix compared to women without removal of the cervix [3]
Summary
Hysterectomy is one of the commonest gynecologic surgical procedures practiced in the United States [1]. Laparoscopic hysterectomy was first described by Reich et al [2]. Laparoscopic Supracervical Hysterectomy (LSH) is a type of hysterectomy that allows the woman to retain her cervix while taking out the part of the uterus that causes the painful periods and heavy vaginal bleeding. There has been no published data to confirm that the cervix helps to maintain pelvic organ support. Many studies have shown the cervix as important for keeping normal sexual function following hysterectomy. Many other studies have shown no difference in sexual function between groups of women undergoing hysterectomy with removal of their cervix compared to women without removal of the cervix [3]
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