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Title: | Comparison of ultrasonic shears and traditional suture ligature for vaginal hysterectomy: Randomized controlled trial. | Authors: | Tsaltas J.;Chan K.-W.;Polyakov A.;Edwards G.N.;Najjar H.;Vollenhoven B. ;Fitz-Gerald A.L.;Tan J. | Institution: | (Fitz-Gerald, Vollenhoven) Monash Medical Center/Southern Health Clayton, Australia (Tan) Hollywood Medical Center, Nedlands, Australia (Chan, Edwards, Najjar, Tsaltas) Monash Medical Centre/Southern Health Moorabbin, Australia (Polyakov) Melbourne IVF East Melbourne, Australia | Issue Date: | 12-Nov-2013 | Copyright year: | 2013 | Publisher: | Elsevier (P.O. Box 211, Amsterdam 1000 AE, Netherlands) | Place of publication: | Netherlands | Publication information: | Journal of Minimally Invasive Gynecology. 20 (6) (pp 853-857), 2013. Date of Publication: 2013. | Abstract: | Study Objective: To compare operating time, intraoperative blood loss, postoperative analgesia, and length of hospital stay using ultrasonic shears vs traditional suture ligature in vaginal hysterectomy. Design(s): Randomized controlled trial (Canadian Task Force classification I). Setting(s): Gynecology units within a single health network, university hospital. Patient(s): Forty women requiring vaginal hysterectomy because of benign disease. Intervention(s): Vaginal hysterectomy performed using either ultrasonically activated shears (USS) or traditional suture ligatures. Measurements and Main Results: Twenty-one patients were randomized to the USS arm, and 19 patients to the traditional suture ligature arm. Patient characteristics were comparable. Mean (SD) hysterectomy time and was similar in both the USS and traditional arms, 28.66 (4.0) minutes vs 32.37 (3.18) minutes (p=.47), as was total operating time, 97.38 (8.9) minutes vs 91.63 (7.69) minutes (p=.63). Operative blood loss was significantly decreased in the USS group: 62.63 (12.46) mL vs 136.05 (21.54) mL (p=.006). There was, however, no significant change in hemoglobin concentration between the 2 groups: 19.53 (1.79) g/L vs -16.72 (2.5) g/L. There was no significant difference in mean oxycodone use: 9.29 (2.66) mg vs 8.06(3.19) mg (p=.77). Length of hospital stay was similar in both groups: 58.98 (3.27) hours vs 60.05 (6.48) hours (p=.88). There was no significant difference in overall complication rates between the groups. Conclusion(s): Although the Harmonic scalpel system, compared with the traditional suture ligation method, seems to be a safe alternative for securing the pedicles in vaginal hysterectomy, it offers no benefit insofar as operative time, reduction in clinically significant blood loss, and analgesic requirements. © 2013 AAGL. | DOI: | http://monash.idm.oclc.org/login?url=http://dx.doi.org/10.1016/j.jmig.2013.05.019 | PubMed URL: | 24183277 [http://www.ncbi.nlm.nih.gov/pubmed/?term=24183277] | ISSN: | 1553-4650 | URI: | https://repository.monashhealth.org/monashhealthjspui/handle/1/27568 | Type: | Article | Subjects: | adult aged article chest infection/co [Complication] clinical article controlled study female hemoglobin determination hemostasis *hospitalization human length of stay *operation duration *operative blood loss polyglactin suture *postoperative analgesia randomized controlled trial *surgical technique ureter injury/co [Complication] urinary tract infection/co [Complication] urine incontinence *vaginal hysterectomy oxycodone *traditional suture ligature *ultrasonic shear *hospitalization human length of stay *operation duration *operative blood loss polyglactin suture *postoperative analgesia randomized controlled trial *surgical technique ureter injury / complication urinary tract infection / complication urine incontinence *vaginal hysterectomy adult article chest infection / complication clinical article controlled study female hemoglobin determination hemostasis aged |
Type of Clinical Study or Trial: | Randomised controlled trial |
Appears in Collections: | Articles |
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