Retrospective Comparison between Ligasure Impact Versus Conventional methods in Elective Cesarean Hysterectomy for placenta accreta in Benha University Hospital | ||
| Benha Medical Journal | ||
| Articles in Press, Accepted Manuscript, Available Online from 06 October 2025 PDF (869.55 K) | ||
| Document Type: Original Article | ||
| DOI: 10.21608/bmfj.2025.409548.2588 | ||
| Authors | ||
| ahmed mousad baioumy ahmed1; Aziza Ali Negm1; Dalia Adel Nour2; Nada Kamal Mohammed2; Ashraf nassif Mahmoud Elmantwe* 3; Fatma Faisal Ibrahim Darwish2 | ||
| 1Assistant professor of obstetrics and gynecology, Faculty of Medicine, Benha University | ||
| 2Assistant professor of obstetrics and gynecology, Al-Qasr Al-Aini, Cairo University, Egypt | ||
| 3Professor of obstetrics and gynecology, Faculty of Medicine, Benha University | ||
| Abstract | ||
| Background: Elective Cesarean Hysterectomy (ECH) for Placenta Accreta Spectrum Disorders (PASD) is a high-risk procedure associated with significant blood loss and morbidity. Efficient vascular control is critical to improve surgical outcomes. Aim: To evaluate the effectiveness of LigaSure Impact™ in reducing intraoperative blood loss and morbidity during ECH in patients with PASD. Patients and Methods: This retrospective study included 160 women diagnosed with PASD who underwent ECH between 2019 and 2024 across a university hospital and affiliated centers. Patients were divided into two cohorts: the LigaSure-assisted group (LIECH, n=56) and the conventional surgery group (CSECH, n=104). Preoperative characteristics were comparable. Intraoperative and postoperative outcomes were analyzed. Results: The LIECH group demonstrated significantly shorter operative time (70±28 vs 90±30 min, p=0.0001) and lower intraoperative blood loss (2150±540 vs 2750±790 ml, p=0.0001). Intraoperative transfusion requirements were significantly reduced in the LIECH group: PRBCs (1.9±1.6 vs 4.4±1.4 units, p=0.0001) and FFP (1.5±0.9 vs 3.4±1.9 units, p=0.0001). Fewer patients required internal iliac artery ligation (44.6% vs 76%, p=0.0001), SICU admission, or surgical revision (9% vs 29%, p=0.004). Postoperative outcomes, including pain scores, analgesic use, drain output, transfusion, and hospital stay (8.3±5.6 vs 13.5±9.8 days, p=0.0003), favored the LIECH group. Vesicovaginal fistula occurred less frequently (1.8% vs 4.8%, p=0.0001). No significant differences were observed in overall postoperative complications, infection rates, or hemoglobin decline. Conclusion: LigaSure Impact™ improves operative efficiency and reduces intraoperative blood loss and postoperative morbidity in ECH for PASD. It may be a safe and effective surgical adjunct in high-risk obstetric surgery. | ||
| Keywords | ||
| : Elective Cesarean Hysterectomy; Placenta Accreta Spectrum Disorders; LigaSure Impact™; Placenta Accreta Spectrum | ||
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