Experience and Efficacy of a Bipolar Vessel Sealing System for Radical Abdominal Hysterectomy

Abstract

The present study evaluated the efficacy of an electrosurgical bipolar vessel sealing system for radical abdominal hysterectomy (RAH). A total of 85 consecutive patients who underwent RAH with pelvic lymphadenectomy for cervical cancer or endometrial cancer were analyzed; in 18 patients, the LigaSure system (Valleylab, Boulder, Colo) was used to secure the vascular pedicles, and in the remaining 67 patients, clamps were used, and the pedicles suture ligated. Compared with the conventional suture group, the patients in the LigaSure group had a significantly shorter operation time (mean, LigaSure 242.8 +/- 36.1 minutes vs conventional, 349.1 +/- 82.6) minutes; P < 0.001) and lower blood loss (mean, 583.1 +/- 287.6 mL vs 999.0 +/- 524.2 mL; P < 0.005). Only 1 (0.06%) of the 18 patients in the LigaSure group was transfused, whereas 27 (40.2%) of the 67 patients in the conventional suture group were transfused. Because transfusion requirements may be affected by the surgeon's bias, we compared blood loss among untransfused patients and found that the LigaSure group still had significantly lower blood loss than the conventional suture group (mean, 550.9 +/- 233.1 mL vs 745.49.0 +/- 230.4 mL; P < 0.01). Hemoglobin level reduction after surgery in untransfused patients was significantly lower in the LigaSure group than in the conventional suture group (mean, 2.31 +/- 2.22 mg/dL vs 3.22 +/- 1.11 mg/dL; P < 0.05). These findings indicate that the LigaSure vessel sealing system is useful to reduce blood loss and shorten operating time at RAH.