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Comparison of the use of LigaSure, HALO PKS cutting forceps, and ENSEAL tissue sealer in total laparoscopic hysterectomy: a randomized trial.

Abstract：

STUDY OBJECTIVE:There are many instruments with different energy modalities or with different properties that are available for use in total laparoscopic hysterectomy. The aim of the study was to compare the use of LigaSure (Valleylab, Boulder, CO), HALO PKS cutting forceps (Gyrus-ACMI, Maple Grove, MA), and ENSEAL tissue sealer (SurgRx, Inc. Redwood City, CA) in total laparoscopic hysterectomy with respect to operation time and blood loss as main outcomes. Perioperative complications, return of gastrointestinal activity, and hospitalization time were assessed as secondary outcomes. DESIGN:Randomized prospective study (Canadian Task Force classification I). SETTING:Adana Numune Training and Research Hospital. PATIENTS:Forty-five patients with the indication of hysterectomy were randomized into 3 groups for total laparoscopic hysterectomy. Patients with malignancies, having 3 or more previous abdominal surgeries, a uterus larger than 12 weeks of gestation, and who had to undergo additional surgical procedures during the same operation were excluded. INTERVENTIONS:Total laparoscopic hysterectomy. MEASUREMENTS AND MAIN RESULTS:Operations were completed in all 15 patients in the LigaSure and HALO PKS Cutting Forceps groups with the planned instruments. In 2 patients in the ENSEAL group, bleeding could not be controlled with ENSEAL, and additional instruments were used. One patient in the ENSEAL group had bladder injury. The mean operation time and blood loss were 52.4 ± 12.8, 51.86 ± 14.11, and 55.7 ± 15.7 minutes (p > .05) and 138 ± 54.3, 118 ± 63.3, and 218 ± 115.9 mL (p < .05) in the LigaSure, HALO PKS, and ENSEAL groups, respectively. Changes in hemoglobin/hematocrit levels, return of gastrointestinal activity, and hospitalization time did not differ between groups. CONCLUSION:These 3 novel bipolar platforms had similar results in total laparoscopic hysterectomy. These instruments were not determined to be independent predictors of operating time and amount of blood loss.

journal_name

J Minim Invasive Gynecol

journal_title

Journal of minimally invasive gynecology

authors

Aytan H,Nazik H,Narin R,Api M,Tok EC

doi

10.1016/j.jmig.2014.01.010

subject

Has Abstract

pub_date

2014-07-01 00:00:00

pages

650-5

issue

eissn

1553-4650

issn

1553-4669

pii

S1553-4650(14)00040-5

journal_volume

pub_type

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Comparison of the use of LigaSure, HALO PKS cutting forceps, and ENSEAL tissue sealer in total laparoscopic hysterectomy: a randomized trial.