Safety and efficacy of using the LigaSure vessel sealing system for securing the pedicles in vaginal hysterectomy: randomised controlled trial

Authors


Dr M. A. Hefni, Department of Gynaecology, Benenden Hospital, Benenden, Kent, TN 17 4AX, UK.

Abstract

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  Randomised controlled trial.

Setting  Gynaecology Department, Benenden Hospital, Kent.

Population  One hundred and sixteen women undergoing vaginal hysterectomy were prospectively randomised to either LigaSure (Group I) or suture ligation (Group II) for securing the pedicles.

Methods  Data of patients were collected prospectively. Statistical analysis was performed using the Mann–Whitney U test, χ2 and Fisher's exact test as appropriate.

Main outcome measures  Operating time, operative blood loss and peri-operative complications.

Results  The operating time was significantly shorter in the LigaSure group compared with the control group (P < 0.04). There was no statistical significant difference between the two groups in operative blood loss (P= 0.433), but peri-operative haemorrhagic complications were less frequent in the LigaSure group (0%vs 6.8%, P= 0.057). Four patients in the control group required either conversion to laparotomy because of bleeding, return to theatre for immediate post-operative haemorrhage or readmission for vault haematoma, whereas none in the LigaSure group had bleeding from unsecured pedicles.

Conclusion  The LigaSure vessel sealing system is a safe alternative for securing pedicles in vaginal hysterectomy when compared with conventional suture ligation. Larger studies are required to determine its place in gynaecological surgery.

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