Sep 6, 2012

Electrosurgical Vessel Sealing Improves Some Outcomes of Vaginal Hysterectomy

Compared with conventional clamping and suturing for vaginal hysterectomy, electrosurgical bipolar vessel sealing reduces early pain and shortens operating times, researchers say.

In earlier randomized trials, bipolar vessel sealing shortened operative times, reduced blood loss and postoperative pain, and shortened hospital stays. The researchers’ current trial looked at those outcomes, as well as recovery, micturition symptoms, and overall costs.

Dr. M. M. E. Lakeman from Academic Medical Center, Amsterdam, The Netherlands and colleagues randomly assigned 100 women undergoing vaginal hysterectomy for benign indications at eight teaching hospitals to be managed with vessel sealing or conventional clamping.

During the evening after surgery, postoperative pain scores were significantly lower for the vessel-sealing group than for the clamping group, but pain scores were comparable thereafter.

Mean operating time was significantly shorter for vessel-sealing than for conventional clamping (59.7 vs 71.3 min; p =0.05), but there was no difference in blood loss or duration of hospital stay.

There were no differences in changes in micturition or defecation symptoms, either.

Inpatient hospital costs were higher in the vessel-sealing group, but the €198 (about US$250) average difference was not statistically significant.

“Surgery seems to be faster using vessel sealing,” the researchers conclude. “However, the shorter operation duration does not completely compensate for the costs.”

“Patients may benefit from the use of a vessel-sealing technique because the postoperative pain during the first night after surgery is less,” they add.

The study was reported online August 24 in BJOG. Dr. Lakeman did not respond to a request for comments.


BJOG 2012.

– Reuters Health


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