Comparison of Bipolar Coagulator and Ultrasonic Surgical System on Laparoscopy-Assisted Vaginal Hysterectomy

Abstract

Objective: This study evaluated the safety and effectiveness of the bipolar coagulator and ultrasonic surgical system on laparoscopy assisted vaginal hysterectomy (LAVH). Methods: This prospective study included 429 patients who had undergone LAVH at the Department of Obstetrics and Gynecology, Chosun University Hospital in Korea, from January 1998 through March 2004. Of these 429 subjects, 152 underwent LAVH with a bipolar coagulator (Group A) and 277 underwent LAVH with an ultrasonic surgical system (Group B). The results of these two methods were postoperatively compared. The X2 test and Student's t test were performed for statistical analysis. A value of p < 0.05 was considered statistically significant. Results: The mean age of the patients in Group A was 46.8 ± 4 years and that of Group B 47.6 ± 6 years. In cases of uterine myoma, there were no significant difference between Group A and B with respect to mean number of myomas, average diameter, longitudinal diameter, and weight of the uterus. The mean operating time, from the time of skin incision through that of skin suturing, was 53 ± 18 minutes for Group A and 41 ± 13 minutes for Group B. The mean operating time of Group B was significantly less than that of Group A. The mean uterine weight of Group A was 370 ± 152 g and that of Group B was 372 ± 134 g. The average hemoglobin reduction for Group A was 2.42 ± 1.2 g/dL whereas that for Group B was 1.85 ± 1.1 g/dL. Conclusion: In cases of uterine myoma or adenomyosis, in which patients underwent LAVH using either a bipolar coagulator or an ultrasonic surgical system, the mean operating time for LAVH with an ultrasonic surgical system was shorter than that of LAVH with a bipolar coagulator. Use of an ultrasonic surgical system involved less bleeding during operation and produced less smoke, facilitating a better surgical view. (J GYNECOL SURG 21:73)