Randomized study of bipolar vessel sealing system versus conventional suture ligature for vaginal hysterectomy

This study was undertaken to compare the use of bipolar vessel sealing system (BVSS) with conventional suture ligature in vaginal hysterectomy (VH) on a non-prolapsed uterus.

Women referred for VH for uterine myoma were randomized to BVSS (n=45) or conventional suture ligature VH (n=45). Exclusion criteria were uterine prolapse and indication associated surgical procedures. Main outcome measures were operative time, blood loss, hospital stay, pain status, peri and post-operative complications. Data of patients were collected prospectively. Statistical analysis was performed using chi-square and Student's t-test as appropriate.

There were no differences in patients' mean age, parity and uterine size between groups. Patients in the BVSS group had a significantly reduced operating time (29.2+/-2.1 min vs. 75.2+/-5 min; p<0.001), operative blood loss (84+/-5.9 mL vs. 136.4+/-89.1 mL; p=0.001), requirement of surgical sutures (1.2+/-0.6 units vs. 7.4+/-0.3 units; p<0.001), pain status (1.6+/-0.4 vs. 3.6+/-0.4; p<0.001) and hospital stay (25.6+/-0.9h vs. 33.2+/-1.7h; p<0.001) compared to the control group. The overall complication rate in the study was 7.8% (7/90), and did not differ between patients of the BVSS and control group.

Bipolar vessel sealing for vaginal hysterectomy appears to be an effective and safe haemostatic control method, with reduced operating time, peri-operative blood losses, post-operative pain and hospital stay.