open access
Safety and efficacy of using advanced electrosurgical bipolar vessel sealing during vaginal hysterectomy in morbidly obese patients: a retrospective cohort analysis
Affiliations- Istanbul Health Sciences, Kanuni Sultan Suleyman Education and Research Hospital
- Istanbul Health Sciences, Bagcilar Education and Research Hospital
open access
Abstract
Objectives: To assess the safety and efficacy of electrosurgical bipolar vessel sealing during vaginal hysterectomy in morbidly obese patients
Material and methods: A total of 105 morbidly obese patients who underwent vaginal hysterectomy due to benign gynecologic pathologies between January 2010 and April 2017 were included in the study. Patients were divided into two groups according to whether conventional suture ligation technique (n = 64) or electrosurgical bipolar vessel sealing (n = 41) were used during vaginal hysterectomy. The surgical procedure was performed with the same technique in both study groups. The primary outcomes were duration of surgery and estimated blood loss. The secondary outcomes were intra-operative complications and post-operative complications.
Results: The duration of surgery and estimated blood loss in the vessel sealing group was significantly less than in the conventional suture group (p < 0.05). No significant difference was present between the two groups in the rate of intra-operative and post-operative complications.
Conclusions: The primary outcome of our study is that the EBVS system can be used equally and even more effectively in some aspects; and as safe an alternative approach to conventional suture ligation technique during vaginal hysterectomies performed specifically on morbidly obese patients with reduced operation times and blood loss, and without increasing the complication rates.
Abstract
Objectives: To assess the safety and efficacy of electrosurgical bipolar vessel sealing during vaginal hysterectomy in morbidly obese patients
Material and methods: A total of 105 morbidly obese patients who underwent vaginal hysterectomy due to benign gynecologic pathologies between January 2010 and April 2017 were included in the study. Patients were divided into two groups according to whether conventional suture ligation technique (n = 64) or electrosurgical bipolar vessel sealing (n = 41) were used during vaginal hysterectomy. The surgical procedure was performed with the same technique in both study groups. The primary outcomes were duration of surgery and estimated blood loss. The secondary outcomes were intra-operative complications and post-operative complications.
Results: The duration of surgery and estimated blood loss in the vessel sealing group was significantly less than in the conventional suture group (p < 0.05). No significant difference was present between the two groups in the rate of intra-operative and post-operative complications.
Conclusions: The primary outcome of our study is that the EBVS system can be used equally and even more effectively in some aspects; and as safe an alternative approach to conventional suture ligation technique during vaginal hysterectomies performed specifically on morbidly obese patients with reduced operation times and blood loss, and without increasing the complication rates.
Keywords
vaginal hysterectomy, vessel sealing, morbid obesity
About this articleTitle
Safety and efficacy of using advanced electrosurgical bipolar vessel sealing during vaginal hysterectomy in morbidly obese patients: a retrospective cohort analysis
Journal
Issue
Article type
Research paper
Pages
523-529
Published online
2017-10-31
Page views
1722
Article views/downloads
1439
DOI
Pubmed
Bibliographic record
Ginekol Pol 2017;88(10):523-529.
Keywords
vaginal hysterectomy
vessel sealing
morbid obesity
Authors
Tolga Karacan
Eser Ozyurek
Lale Susan Wetherilt
Huseyin Kiyak
Salman Yilmaz
Erdal Kaya
References (20)- World Health Organization. Country profiles on nutrition, physical activity and obesity in the 53 WHO European Region Member States. WHO website. http://www euro who int/__data/assets/pdf_file/0004/243337/Summary-document-53-MS-country-profile pdf (2013 07).
- ACOG Committee Opinion No. 444: choosing the route of hysterectomy for benign disease. Obstet Gynecol. 2009; 114(5): 1156–1158.
- Muffly TM, Kow NS. Effect of obesity on patients undergoing vaginal hysterectomy. J Minim Invasive Gynecol. 2014; 21(2): 168–175.
- Harmanli OH, Dandolu V, Isik EF, et al. Does obesity affect the vaginal hysterectomy outcomes? Arch Gynecol Obstet. 2011; 283(4): 795–798.
- Sheth SS. Vaginal Hysterectomy. 2nd ed. Jaypee Brothers (UK) Medical Publishers LTD. ; 2014.
- Nieboer TE, Johnson N, Tavender E, et al. Surgical approach to hysterectomy for benign gynaecological disease. Cochrane Database Syst Rev. 2009(3): CD003677.
- Cronjé HS, de Coning EC. Electrosurgical bipolar vessel sealing during vaginal hysterectomy. Int J Gynaecol Obstet. 2005; 91(3): 243–245.
- Rafii A, Samain E, Levardon M, et al. Vaginal hysterectomy for benign disorders in obese women: a prospective study. BJOG. 2005; 112(2): 223–227.
- Bogani G, Cromi A, Serati M, et al. Laparoscopic and vaginal approaches to hysterectomy in the obese. Eur J Obstet Gynecol Reprod Biol. 2015; 189: 85–90.
- Sheth SS. Vaginal hysterectomy as a primary route for morbidly obese women. Acta Obstet Gynecol Scand. 2010; 89(7): 971–974.
- Ding Z, Wable M, Rane A. Use of Ligasure bipolar diathermy system in vaginal hysterectomy. J Obstet Gynaecol. 2005; 25(1): 49–51.
- Zubke W, Hornung R, Wässerer S, et al. Bipolar coagulation with the BiClamp forceps versus conventional suture ligation: a multicenter randomized controlled trial in 175 vaginal hysterectomy patients. Arch Gynecol Obstet. 2009; 280(5): 753–760.
- Kroft J, Selk A. Energy-based vessel sealing in vaginal hysterectomy: a systematic review and meta-analysis. Obstet Gynecol. 2011; 118(5): 1127–1136.
- Samulak D, Wilczak M, Michalska MM, et al. Vaginal hysterectomy with bipolar coagulation forceps (BiClamp) as an alternative to the conventional technique. Arch Gynecol Obstet. 2011; 284(1): 145–149.
- Silva-Filho AL, Rodrigues AM, Vale de Castro Monteiro M, et al. Randomized study of bipolar vessel sealing system versus conventional suture ligature for vaginal hysterectomy. Eur J Obstet Gynecol Reprod Biol. 2009; 146(2): 200–203.
- Lakeman MME, The S, Schellart RP, et al. Electrosurgical bipolar vessel sealing versus conventional clamping and suturing for vaginal hysterectomy: a randomised controlled trial. BJOG. 2012; 119(12): 1473–1482.
- Elhao M, Abdallah K, Serag I, et al. Efficacy of using electrosurgical bipolar vessel sealing during vaginal hysterectomy in patients with different degrees of operative difficulty: a randomised controlled trial. Eur J Obstet Gynecol Reprod Biol. 2009; 147(1): 86–90.
- ACOG CommitteeOpinion No. 578: Elective surgery and patient choice. Obstet Gynecol. 2013; 122(5): 1134–1138.
- Davies A, Vizza E, Bournas N, et al. How to increase the proportion of hysterectomies performed vaginally. Am J Obstet Gynecol. 1998; 179(4): 1008–1012.
- Hefni MA, Bhaumik J, El-Toukhy T, et al. Safety and efficacy of using the LigaSure vessel sealing system for securing the pedicles in vaginal hysterectomy: randomised controlled trial. BJOG. 2005; 112(3): 329–333.
