Total laparoscopic hysterectomy using multifunction grasping, coagulating, and cutting forceps

Area of Science:

• Minimally Invasive Surgery
• Gynecologic Surgery
• Surgical Technology

Background:

• Total laparoscopic hysterectomy (LH) is a common gynecologic procedure.
• Traditional instrumentation for LH involves multiple separate tools for grasping, cutting, and coagulation.
• Advancements in surgical technology aim to improve efficiency and patient outcomes.

Purpose of the Study:

• To compare the efficacy and safety of multifunction PlasmaKinetic (PK) cutting forceps versus traditional instruments (Kleppinger forceps and endoscopic scissors) in total laparoscopic hysterectomy.
• To evaluate differences in surgery time, estimated blood loss, and costs between the two instrumentation groups.

Main Methods:

• A retrospective review of 123 total laparoscopic hysterectomies performed by a single surgeon.
• Patients were divided into two groups based on instrumentation used: Kleppinger forceps/endoscopic scissors or PlasmaKinetic (PK) multifunction forceps.
• Data collected included surgery time, estimated blood loss, and instrument costs.

Main Results:

• The PK system was associated with significantly lower estimated blood loss in both LH alone and LH with bilateral salpingo-oopherectomy procedures.
• No significant difference in mean surgery time was observed between the groups.
• The PK system resulted in approximately $70 greater disposable instrumentation costs per procedure but eliminated the need for a third instrument cannula and reduced instrument exchanges.

Conclusions:

• Multifunction PK cutting forceps offer reduced blood loss and improved safety (less plume, quicker coagulation, less charring) in total laparoscopic hysterectomy compared to traditional instruments.
• Despite higher initial costs, the PK system may offer benefits in terms of procedural efficiency and safety.
• Further research could explore long-term patient outcomes and cost-effectiveness.