open access

Vol 90, No 11 (2019)
ORIGINAL PAPERS Gynecology
Published online: 2019-11-28
Get Citation

Perioperative outcomes of bipolar energy instruments in total laparoscopic hysterectomy

Yakup Yalcin, Serenat Eris Yalcin
DOI: 10.5603/GP.2019.0112
·
Pubmed: 31802464
·
Ginekol Pol 2019;90(11):640-644.

open access

Vol 90, No 11 (2019)
ORIGINAL PAPERS Gynecology
Published online: 2019-11-28

Abstract

Objectives: To compare conventional and advanced bipolar energy instruments in terms of perioperative outcomes in patients who underwent total laparoscopic hysterectomy (TLH). 

Material and methods: The data of 101 patients who underwent TLH between June 2017 and December 2018 for benign gynecological disorders were analyzed retrospectively. Conventional bipolar forceps (Robi forceps) were used in 37 patients and advanced bipolar instruments (LigaSure) were used in 64 patients. Data about the characteristics of the patients, operation time, estimated blood loss, length of hospital stay and other perioperative outcomes were compared. 

Results: The mean ages of the patients in the conventional bipolar and LigaSure groups were 47.6 ± 6.5 and 48.1 ± 7 years, respectively (p > 0.05). There was no statistically significant difference between the two groups with regard to all other patient characteristics; body mass index, parity, previous pelvic operation and indications of hysterectomy (p > 0.05). The mean operation time (41 ± 13.2 vs 37 ± 11.5 min), estimated intraoperative blood loss (70 ± 22 vs 65 ± 21 mL) and absolute change in hemoglobin (-1.23 ± 1.12 vs -1.11 ± 1.14 g/dL) were slightly higher in the conventional bipolar group. However, there was no statistical significance with respect to these differences between the groups (p > 0.05). 

Conclusions: Our findings indicate that a conventional bipolar system is as safe and effective as LigaSure, and it may be used as an alternative option for patients undergoing TLH in low-income hospitals.

Abstract

Objectives: To compare conventional and advanced bipolar energy instruments in terms of perioperative outcomes in patients who underwent total laparoscopic hysterectomy (TLH). 

Material and methods: The data of 101 patients who underwent TLH between June 2017 and December 2018 for benign gynecological disorders were analyzed retrospectively. Conventional bipolar forceps (Robi forceps) were used in 37 patients and advanced bipolar instruments (LigaSure) were used in 64 patients. Data about the characteristics of the patients, operation time, estimated blood loss, length of hospital stay and other perioperative outcomes were compared. 

Results: The mean ages of the patients in the conventional bipolar and LigaSure groups were 47.6 ± 6.5 and 48.1 ± 7 years, respectively (p > 0.05). There was no statistically significant difference between the two groups with regard to all other patient characteristics; body mass index, parity, previous pelvic operation and indications of hysterectomy (p > 0.05). The mean operation time (41 ± 13.2 vs 37 ± 11.5 min), estimated intraoperative blood loss (70 ± 22 vs 65 ± 21 mL) and absolute change in hemoglobin (-1.23 ± 1.12 vs -1.11 ± 1.14 g/dL) were slightly higher in the conventional bipolar group. However, there was no statistical significance with respect to these differences between the groups (p > 0.05). 

Conclusions: Our findings indicate that a conventional bipolar system is as safe and effective as LigaSure, and it may be used as an alternative option for patients undergoing TLH in low-income hospitals.

Get Citation

Keywords

conventional bipolar instrument; LigaSure; vessel sealing; total laparoscopic hysterectomy

About this article
Title

Perioperative outcomes of bipolar energy instruments in total laparoscopic hysterectomy

Journal

Ginekologia Polska

Issue

Vol 90, No 11 (2019)

Pages

640-644

Published online

2019-11-28

DOI

10.5603/GP.2019.0112

Pubmed

31802464

Bibliographic record

Ginekol Pol 2019;90(11):640-644.

Keywords

conventional bipolar instrument
LigaSure
vessel sealing
total laparoscopic hysterectomy

Authors

Yakup Yalcin
Serenat Eris Yalcin

References (23)
  1. ACOG Committee Opinion No. 444: choosing the route of hysterectomy for benign disease. Obstet Gynecol. 2009; 114(5): 1156–1158.
  2. Kluivers KB, Opmeer BC, Geomini PM, et al. Women's preference for laparoscopic or abdominal hysterectomy. Gynecol Surg. 2009; 6(3): 223–228.
  3. Wang CJ, Yuen LT, Yen CF, et al. Comparison of the efficacy of the pulsed bipolar system and conventional bipolar electrosurgery in laparoscopically assisted vaginal hysterectomy. J Laparoendosc Adv Surg Tech A. 2005; 15(4): 361–364.
  4. Ayroza P, Abdalla E. Manual of Gynecological Laparoscopic Surgery: Use of Electricity in Laparoscopy, 2nd ed. Tuttlingen, Germany: Endo Press. ; 2010: 43.
  5. Harold KL, Pollinger H, Matthews BD, et al. Comparison of ultrasonic energy, bipolar thermal energy, and vascular clips for the hemostasis of small-, medium-, and large-sized arteries. Surg Endosc. 2003; 17(8): 1228–1230.
  6. Alkatout I, Schollmeyer T, Hawaldar NA, et al. Principles and safety measures of electrosurgery in laparoscopy. JSLS. 2012; 16(1): 130–139.
  7. Richter S, Kollmar O, Schilling MK, et al. Efficacy and quality of vessel sealing: comparison of a reusable with a disposable device and effects of clamp surface geometry and structure. Surg Endosc. 2006; 20(6): 890–894.
  8. Landman J, Kerbl K, Rehman J, et al. Evaluation of a vessel sealing system, bipolar electrosurgery, harmonic scalpel, titanium clips, endoscopic gastrointestinal anastomosis vascular staples and sutures for arterial and venous ligation in a porcine model. J Urol. 2003; 169(2): 697–700.
  9. Kennedy JS, Stranahan PL, Taylor KD, et al. High-burst-strength, feedback-controlled bipolar vessel sealing. Surg Endosc. 1998; 12(6): 876–878.
  10. Goldstein SL, Harold KL, Lentzner A, et al. Comparison of thermal spread after ureteral ligation with the Laparo-Sonic ultrasonic shears and the Ligasure system. J Laparoendosc Adv Surg Tech A. 2002; 12(1): 61–63.
  11. Demirturk F, Aytan H, Caliskan AC. Comparison of the use of electrothermal bipolar vessel sealer with harmonic scalpel in total laparoscopic hysterectomy. J Obstet Gynaecol Res. 2007; 33(3): 341–345.
  12. Hagen B, Eriksson N, Sundset M. Randomised controlled trial of LigaSure versus conventional suture ligature for abdominal hysterectomy. BJOG. 2005; 112(7): 968–970.
  13. Heniford BT, Matthews BD, Sing RF, et al. Initial results with an electrothermal bipolar vessel sealer. Surg Endosc. 2001; 15(8): 799–801.
  14. Crawford ED. Use of the LigaSure vessel sealing system in urologic cancer surgery. Grand Rounds Urology. 1999; 1: 10–17.
  15. Guerrieri M, Sanctis A, Baldarelli M, et al. Electrothermal bipolar energy-based device in laparoscopic right colectomy: our experience. Minerva Chir. 2008; 63(6): 455–460.
  16. Janssen PF, Brölmann HAM, van Kesteren PJM, et al. Perioperative outcomes using LigaSure compared with conventional bipolar instruments in laparoscopic hysterectomy: a randomised controlled trial. BJOG. 2011; 118(13): 1568–1575.
  17. Bessa SS. Ligasure vs. conventional diathermy in excisional hemorrhoidectomy: a prospective, randomized study. Dis Colon Rectum. 2008; 51(6): 940–944.
  18. Taşkın S, Şükür YE, Altın D, et al. Bipolar Energy Instruments in Laparoscopic Uterine Cancer Surgery: A Randomized Study. J Laparoendosc Adv Surg Tech A. 2018; 28(6): 645–649.
  19. Cho HY, Choi KJ, Lee YL, et al. Comparison of two bipolar systems in laparoscopic hysterectomy. JSLS. 2012; 16(3): 456–460.
  20. Wang JY, Lu CY, Tsai HL, et al. Randomized controlled trial of LigaSure with submucosal dissection versus Ferguson hemorrhoidectomy for prolapsed hemorrhoids. World J Surg. 2006; 30(3): 462–466.
  21. Seehofer D, Mogl M, Boas-Knoop S, et al. Safety and efficacy of new integrated bipolar and ultrasonic scissors compared to conventional laparoscopic 5-mm sealing and cutting instruments. Surg Endosc. 2012; 26(9): 2541–2549.
  22. Garry R, Fountain J, Mason Su, et al. The eVALuate study: two parallel randomised trials, one comparing laparoscopic with abdominal hysterectomy, the other comparing laparoscopic with vaginal hysterectomy. BMJ. 2004; 328(7432): 129.
  23. Rothmund R, Kraemer B, Brucker S, et al. Laparoscopic supracervical hysterectomy using EnSeal vs standard bipolar coagulation technique: randomized controlled trial. J Minim Invasive Gynecol. 2013; 20(5): 661–666.

Important: This website uses cookies. More >>

The cookies allow us to identify your computer and find out details about your last visit. They remembering whether you've visited the site before, so that you remain logged in - or to help us work out how many new website visitors we get each month. Most internet browsers accept cookies automatically, but you can change the settings of your browser to erase cookies or prevent automatic acceptance if you prefer.

By "Via Medica sp. z o.o." sp.k., ul. Świętokrzyska 73, 80–180 Gdańsk
tel.:+48 58 320 94 94, faks:+48 58 320 94 60, e-mail:  viamedica@viamedica.pl