16413

LigaSure versus Conventional Suture Ligature for Vaginal Hysterectomy: a Randomized Controlled Trial

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Last updated: 03 Jan 2025

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Abstract

Introduction: Vaginal hysterectomy is considered to be the method of choice for removal of the uterus. Of particular concern for the vaginal surgeon is the ability to access, visualize, and legate structures while maintaining adequate hemostasis. Surgical hemostasis can be secured by a variety of methods, including mechanical means (sutures) or vessel coagulation (diathermy). Electro-surgical vessel sealing (LigaSure) is a new hemostatic system based on the combination of pressure and bipolar electrical energy and is able to seal vessels up to 7 mm in diameter.   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: Prospective randomized controlled trial.   Setting: Obstetrics and Gynecology departments (Al-Kharj University Hospital- KSA, Enjab Hospital - UAE and Gulf Medical College and Research Centre- UAE). Methods: 80 patients undergoing vaginal hysterectomy for benign conditions were randomized to either LigaSure group (n=40) or Suture group (n=40).   Main outcome measures: The primary outcome measures were the operative time and blood loss while the secondary outcome measures were the hospital stay and intra- and post-operative complications.   Results: Patients in the LigaSure group had a significantly reduced operating time (37.1 ±  8.9 min vs. 63.8 ± 10.9  min; P < 0.001), operative blood loss (125.5 ± 33.2 mL vs. 264.6 ± 70.4 mL; P < 0.001), requirement of surgical sutures(1.2 ± 0.4 units vs. 8.2 ± 0.4 units; p < 0.001), pain status (2.0 ± 0.6 vs. 3.7 ± 0.7; P < 0.001), and hospital stay (30.3 ± 2.5 h vs. 45.7 ±10.5 h; P < 0.001) compared to the control group. The overall complication rate in the study was 10 % (8/80), and did not differ between patients of the LigaSure and control group.   Conclusion: The use of LigaSure device can reduce operative time. It allows faster, safe and effective hemostasis compared with the conventional suture ligature. It also reduces the operative blood loss, pain status and hospital stays.      

DOI

10.21608/ejhm.2011.16413

Keywords

LigaSure (Electro-surgical vessel sealing)

Authors

First Name

Mohamed

Last Name

Abd Elzaher

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Affiliation

(Al-Azhar University, Cairo, Egypt)

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First Name

Ashraf

Last Name

Moawad

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Affiliation

Al-Kharj University Hospital (KSA),

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First Name

Hanaa

Last Name

Abu-Ria

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Affiliation

Gulf Medical College and Research Centre (UAE).

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Volume

44

Article Issue

1

Related Issue

3508

Issue Date

2011-07-01

Receive Date

2018-10-11

Publish Date

2011-07-01

Page Start

344

Page End

353

Print ISSN

1687-2002

Online ISSN

2090-7125

Link

https://ejhm.journals.ekb.eg/article_16413.html

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https://ejhm.journals.ekb.eg/service?article_code=16413

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8

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Original Article

Type Code

606

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Journal

Publication Title

The Egyptian Journal of Hospital Medicine

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https://ejhm.journals.ekb.eg/

MainTitle

LigaSure versus Conventional Suture Ligature for Vaginal Hysterectomy: a Randomized Controlled Trial

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Article

Created At

22 Jan 2023