Perioperative Outcomes using LigaSure Compared with Conventional Bipolar Instruments in Laparoscopic Hysterectomy for Benign Gynaecological Disease in Ain Shams University Maternity Hospital: A Randomized Controlled Trial

Abstract

H ysterectomy is one of the most frequently performed gynaecologic surgical procedures. Since the introduction of laparoscopic surgery, different haemostatic instruments have been developed. In laparoscopic surgery, conventional mechanical haemostatic techniques, using sutures or clips, have almost completely been replaced by coagulation techniques, using monopolar coagulation, bipolar coagulation and ultrasonic instruments. LigaSure (Valleylab, Boulder, CO, USA) desiccates vascular tissues using a feedback-programmed amount of bipolar diathermy. Conventional bipolar instruments are generally safer than monopolar instruments, they achieve their haemostatic vessel-sealing effect through mechanical compression and the electrosurgical effects of desiccation and coagulation of the grasped tissue in between the two electrodes. On the other hand, LigaSure has a shorter operative time than conventional bipolar instruments. The reason for this increase in time was changing of the instruments for sealing and cutting during the operation in conventional device groups. Additionally, the current delivered with LigaSure takes up to 7 seconds to achieve homeostasis. LigaSure also can shorten the duration of hospital stay by decreasing the incidence of major complications. In our study that was carried out in 2 years, we aimed to compare the effects of LigaSure versus the conventional bipolar technique on operating time and blood loss during laparoscopic hysterectomy.