LigaSure versus Conventional Suture Ligature for Vaginal Hysterectomy: a Randomized Controlled Trial | ||||
| The Egyptian Journal of Hospital Medicine | ||||
| Article 8, Volume 44, Issue 1, July 2011, Page 344-353 PDF (381.1 K) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/ejhm.2011.16413 | ||||
 View on SCiNiTO | ||||
| Authors | ||||
| Mohamed Abd Elzaher1; Ashraf Moawad2; Hanaa Abu-Ria3 | ||||
| 1(Al-Azhar University, Cairo, Egypt) | ||||
| 2Al-Kharj University Hospital (KSA), | ||||
| 3Gulf Medical College and Research Centre (UAE). | ||||
| Abstract | ||||
| Introduction: Vaginal hysterectomy is considered to be the method of choice for removal of the uterus. Of particular concern for the vaginal surgeon is the ability to access, visualize, and legate structures while maintaining adequate hemostasis. Surgical hemostasis can be secured by a variety of methods, including mechanical means (sutures) or vessel coagulation (diathermy). Electro-surgical vessel sealing (LigaSure) is a new hemostatic system based on the combination of pressure and bipolar electrical energy and is able to seal vessels up to 7 mm in diameter. Objective: To assess the safety and efficacy of using the LigaSure vessel sealing system for securing the pedicles during vaginal hysterectomy in comparison with the conventional method of securing the pedicles by suture ligation. Design: Prospective randomized controlled trial. Setting: Obstetrics and Gynecology departments (Al-Kharj University Hospital- KSA, Enjab Hospital - UAE and Gulf Medical College and Research Centre- UAE). Methods: 80 patients undergoing vaginal hysterectomy for benign conditions were randomized to either LigaSure group (n=40) or Suture group (n=40). Main outcome measures: The primary outcome measures were the operative time and blood loss while the secondary outcome measures were the hospital stay and intra- and post-operative complications. Results: Patients in the LigaSure group had a significantly reduced operating time (37.1 ± 8.9 min vs. 63.8 ± 10.9 min; P < 0.001), operative blood loss (125.5 ± 33.2 mL vs. 264.6 ± 70.4 mL; P < 0.001), requirement of surgical sutures(1.2 ± 0.4 units vs. 8.2 ± 0.4 units; p < 0.001), pain status (2.0 ± 0.6 vs. 3.7 ± 0.7; P < 0.001), and hospital stay (30.3 ± 2.5 h vs. 45.7 ±10.5 h; P < 0.001) compared to the control group. The overall complication rate in the study was 10 % (8/80), and did not differ between patients of the LigaSure and control group. Conclusion: The use of LigaSure device can reduce operative time. It allows faster, safe and effective hemostasis compared with the conventional suture ligature. It also reduces the operative blood loss, pain status and hospital stays. | ||||
| Keywords | ||||
| LigaSure (Electro-surgical vessel sealing) | ||||
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