Trial registration: Nederlands Trial Register: Trial number NTR 1795. Acronym: Ligasure (http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=1795).
Electrosurgical bipolar vessel sealing versus conventional clamping and suturing for vaginal hysterectomy: a randomised controlled trial
Article first published online: 24 AUG 2012
© 2012 The Authors BJOG An International Journal of Obstetrics and Gynaecology © 2012 RCOG
BJOG: An International Journal of Obstetrics & Gynaecology
Volume 119, Issue 12, pages 1473–1482, November 2012
How to Cite
Lakeman, M., The, S., Schellart, R., Dietz, V., ter Haar, J., Thurkow, A., Scholten, P., Dijkgraaf, M. and Roovers, J. (2012), Electrosurgical bipolar vessel sealing versus conventional clamping and suturing for vaginal hysterectomy: a randomised controlled trial. BJOG: An International Journal of Obstetrics & Gynaecology, 119: 1473–1482. doi: 10.1111/j.1471-0528.2012.03484.x
- Issue published online: 11 OCT 2012
- Article first published online: 24 AUG 2012
- Accepted 17 July 2012. Published Online 24 August 2012.
- electrosurgical bipolar vessel sealing;
- pain score;
- vaginal hysterectomy
Please cite this paper as: Lakeman M, The S, Schellart R, Dietz V, ter Haar J, Thurkow A, Scholten P, Dijkgraaf M, Roovers J. Electrosurgical bipolar vessel sealing versus conventional clamping and suturing for vaginal hysterectomy: a randomised controlled trial. BJOG 2012;119:1473–1482.
Objective To compare the effects of electrical bipolar vessel sealing and conventional suturing on postoperative pain, recovery, costs and micturition symptoms in women undergoing vaginal hysterectomy.
Design Randomised controlled trial.
Setting Eight teaching hospitals in the Netherlands.
Population One hundred women scheduled to undergo vaginal hysterectomy for benign conditions excluding pelvic organ prolapse.
Methods Women were randomised to vessel sealing or conventional surgery. The quality of life related to pelvic floor function was assessed using validated questionnaires before surgery and 6 months after surgery. Pain scores and recovery were assessed using a diary, including daily visual analogue scale scores, starting from the day before surgery until 6 weeks after surgery.
Main outcome measures Visual analogue scale pain scores, surgery time, blood loss, complications, quality of life related to pelvic floor function and costs.
Results The evening after surgery, women in the vessel-sealing group reported significantly less pain (5.7 versus 4.5 on a scale of 0–10, P = 0.03), but after that pain scores were similar. Operation duration was shorter for vessel sealing (60 versus 71 minutes, P = 0.05). Blood loss and hospital stay did not differ. We observed no major difference in costs between the two interventions (2903 versus 3102 €, P = 0.26). Changes in micturition and defecation symptoms were not affected by the surgical technique used.
Conclusion Using vessel sealing during vaginal hysterectomy resulted in less pain on the first postoperative day, shorter operating time, similar morbidity and similar pelvic floor function. No major differences in costs were found between the two interventions.