R. Bruno

Ligasure versus sutures in total abdominal hysterectomy

Abstract Objective: To compare the LigaSure vessel sealer to sutures in total abdominal hysterectomy (TAH). Methods: 50 patients undergoing TAH were randomized to either LigaSure or sutures as the hemostasis technique. Procedure time was defined as time from abdominal incision to closure of the vaginal cuff with satisfactory hemostasis. Blood loss was estimated by the anesthesia service. Statistical methodology included the Students T test and all comparisons were two-tailed with p less than 0.05 considered significant. Results: Procedure time was significantly less in the LigaSure arm, 30.6 minutes (range: 18min-62min) versus 48.2 minutes (range: 30min-109min) in the suture arm (p less than 0.001). Blood loss was significantly less in the LigaSure arm with an average of 74.2 cc (range: 32cc-50cc) versus 118.7 cc (range: 25cc-250cc) in the suture arm (p equals 0.02). There was no post-operative hemorrhage or return to the operating room in either arm. Two patients, one in each arm, received two units of blood for a slowly decreasing hematocrit on postoperative day 3. There was no evidence of collateral tissue injury and no injuries to the urinary or intestinal tract in either arm. Conclusions: LigaSure is a safe and effective alternative to sutures in TAH, resulting in decreased blood loss and significant timesaving.