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Ginecología y Obstetricia de México

Federación Mexicana de Ginecología y Obstetricia, A.C.
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2009, Number 12

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Ginecol Obstet Mex 2009; 77 (12)

Use of plasmakinetics vessel sealing vs suture material in abdominal total hysterectomy

Briones LCH, Zepeda ZJ, Dupré AG, Cruz IML
Full text How to cite this article

Language: Spanish
References: 10
Page: 556-561
PDF size: 310.61 Kb.


Key words:

hysterectomy, bipolar energy, plasmakinetics.

ABSTRACT

Objective: To compare the safety and efficacy of the use of bipolar plasmakinetic vessel sealing versus standard technique when performing total abdominal hysterectomy for benign disease.
Material and methods: Controlled randomized trial involving 94 women who underwent total abdominal hysterectomy. Fourty seven procedures were performed using bipolar plasmakinetics vessel sealing and the remaining 47 with the standard suture technique. The primary outcomes were improvement in terms of blood loss, procedure time, hospital length of stay, and overall cost of the procedure. Statistical methodology considered significant p ‹0.05.
Results: Mean operational time was shorter with bipolar vessel sealing duration of 82 minutes (range 78-85) versus 99 minutes (range 93-104) with standard technique; (p ‹0.001). Days in hospital for the bipolar vessel sealing group was 2.06 days (range 2-2.1), versus 3.2 days (range 2.9-3.4), (p‹0.001), estimated blood loss of 209 mL (range 182-235) as compared to the standard group with 330 mL(range 297-362) (p ‹0.003), there was a significant difference in terms of overall cost with bipolar vessel sealing as compared to the standard technique (p ‹0.001).The incidence of perioperative complications was similar.
Conclusions: Women who underwent the procedure with bipolar plasmakinetics vessel sealing showed a significant reduction in blood loss, operative time, length of stay, and also a decrease in the final cost of the procedure.


REFERENCES

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  2. Nezhat C, Nezhat F, Nezahat C. Nezhat’s Operative Gynecologic Laparoscopy and Hysteroscopy. 3rd ed. Cambridge: University Press, 2008;13:341-62.

  3. Farqhuar CM, Steiner C. Hysterectomy Rates in the United States 1990-1997. Obstet Gynecol 2002;99:229-34.

  4. Broder et al. The appropriateness of recommendations for hysterectomy. Obstet Gynecol 2000;95:199-205.

  5. Presthus J, et al. Vessel sealing using a pulsed bipolar system and open forceps. J Am Assoc Gynecol Laparosc 2003;4:528-33.

  6. Levie MD, Chudnoff SG. Energy sources for endoscopic surgery. Abstracts for the Global Congress of Gynecologic Endoscopy. 33rd annual meeting of the AAGL. August 2004, Vol. 11 No. 3 Supplement.

  7. Pietrow PK, Weizer WAZ, L’Esperance JO, Auge BK, et al. PlasmaKinetic bipolar vessel sealing: burst pressures and thermal spread in an animal model. J Endourol 2005;19:107-10.

  8. Cronjé HS, De Coning EC: Electrosurgical bipolar vessel sealing during vaginal hysterectomy. Int J Gynecol Obstet 2005;91:243-5.

  9. Hagen B, Eriksson N. Randomised controlled trial of LigaSure versus conventional suture ligature for abdominal hysterectomy. BJOG 2005;112:968-70.

  10. Dessole D, Rubattu G. Utility of bipolar electrocautery scissors for abdominal hysterectomy. Am J Obs Gynecol 2000;183.




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Ginecol Obstet Mex. 2009;77