Total Laparoscopic Hysterectomy with Harmonic Ultracision

Abstract

Study ObjectiveTo analyze the feasibility, technique, blood loss and duration of surgery in patients who underwent total laparoscopic hysterectomy (TLH) with the harmonic ultracision.The contribution of the Ultracision Harmonic ACE scalpel to this procedure cannot be under estimated as it possesses virtually all the features one would consider in the ideal electromagnetic energy form. Its use facilitates dissection, minimizes tissue trauma and has reduced blood loss, enabling TLH to become a day care procedure.DesignRetrospective review (Canadian Task Force Classification II-1).SettingDedicated high volume Gynecological laparoscopy centre.Patients420 women who underwent total laparoscopic hysterectomy at our center from 2006-2010. There were no exclusion criteria based on the size of the uterus or the number of previous surgeries.InterventionView Large Image Figure ViewerDownload Hi-res image Download (PPT)Measurements and Main Results77% of patients had previous normal vaginal delivery and 23% had previous cesarean section. The median clinical size of the uterus was 10 weeks (6, 30). The median weight of the specimen was 220 grams (60, 1760). The median duration of surgery was 60 min (20, 240) and the median blood loss was 40 ml (10, 500).ConclusionTotal laparoscopic hysterectomy with harmonic ultracision considerably reduces the time of surgery and blood loss with added advantage of minimal lateral thermal spread. It can be used by experienced surgeons in all cases of total laparoscopic hysterectomy for all pedicles irrespective of the size of the uterus. Study ObjectiveTo analyze the feasibility, technique, blood loss and duration of surgery in patients who underwent total laparoscopic hysterectomy (TLH) with the harmonic ultracision.The contribution of the Ultracision Harmonic ACE scalpel to this procedure cannot be under estimated as it possesses virtually all the features one would consider in the ideal electromagnetic energy form. Its use facilitates dissection, minimizes tissue trauma and has reduced blood loss, enabling TLH to become a day care procedure. To analyze the feasibility, technique, blood loss and duration of surgery in patients who underwent total laparoscopic hysterectomy (TLH) with the harmonic ultracision.The contribution of the Ultracision Harmonic ACE scalpel to this procedure cannot be under estimated as it possesses virtually all the features one would consider in the ideal electromagnetic energy form. Its use facilitates dissection, minimizes tissue trauma and has reduced blood loss, enabling TLH to become a day care procedure. DesignRetrospective review (Canadian Task Force Classification II-1). Retrospective review (Canadian Task Force Classification II-1). SettingDedicated high volume Gynecological laparoscopy centre. Dedicated high volume Gynecological laparoscopy centre. Patients420 women who underwent total laparoscopic hysterectomy at our center from 2006-2010. There were no exclusion criteria based on the size of the uterus or the number of previous surgeries. 420 women who underwent total laparoscopic hysterectomy at our center from 2006-2010. There were no exclusion criteria based on the size of the uterus or the number of previous surgeries. Intervention Measurements and Main Results77% of patients had previous normal vaginal delivery and 23% had previous cesarean section. The median clinical size of the uterus was 10 weeks (6, 30). The median weight of the specimen was 220 grams (60, 1760). The median duration of surgery was 60 min (20, 240) and the median blood loss was 40 ml (10, 500). 77% of patients had previous normal vaginal delivery and 23% had previous cesarean section. The median clinical size of the uterus was 10 weeks (6, 30). The median weight of the specimen was 220 grams (60, 1760). The median duration of surgery was 60 min (20, 240) and the median blood loss was 40 ml (10, 500). ConclusionTotal laparoscopic hysterectomy with harmonic ultracision considerably reduces the time of surgery and blood loss with added advantage of minimal lateral thermal spread. It can be used by experienced surgeons in all cases of total laparoscopic hysterectomy for all pedicles irrespective of the size of the uterus. Total laparoscopic hysterectomy with harmonic ultracision considerably reduces the time of surgery and blood loss with added advantage of minimal lateral thermal spread. It can be used by experienced surgeons in all cases of total laparoscopic hysterectomy for all pedicles irrespective of the size of the uterus.