Background: non-descent vaginal hysterectomy (NDVH)is the
differentiating procedure of gynecologic surgeons, introducing a
new technique is crucial. Aim: To contrast perioperative
consequences of employing Covidien LigaSure Impact™ with
built-in add-on knife (Curved Large Jaw Open Sealer / Divider)
and ERBE BiClamp®200C (Curved Sealer) standalone forceps
with use of separate scissors for executing NDVH. Patients and
methods: A retrospective analysis included 164 NDVH executed
between January 2015 and April 2023 in Benha University
Hospital. The LigaSure Impact™ group included 86 NDVH. The
BiClamp® group included 78 NDVH. Results: Both groups
showed no significant dissimilarity regarding their age, BMI,
parity, preoperative mean hemoglobin levels, associated
comorbidities, numbers of prior Cesarean section (CS), the
indications for hysterectomy, the preoperative HBA1c or the
preoperative hospital administration(P>0.05). Also, there was no
difference between both groups in operative time, blood loss,
removed uterine weight, intra-operative complications, need for
blood transfusion, rates of incidental cystotomy, need for
additional general anesthesia intraoperatively, shorter
postoperative hospital stay, wound complications, less
consumption of analgesic and lower amount as well as the need
for postoperative venous thromboembolic prophylaxis (VTE),
earlier ambulation, earlier return to daily activity, earlier
resumption of coital activity, need to reoperate for wound-related
complication (P>0.05). Conclusion: NDVH could be safely and
efficiently achieved either Covidien LigaSure Impact™ or by
ERBE BiClamp®200C. The gynecologist should follow the
recommendations of gynecologic societies at least for feasible
mobile non-scared uteri with uterine size up to 12 weeks needed
to be extirpated to be accomplished vaginally |
