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A case-controlled study comparing harmonic versus electrosurgery in laparoscopic myomectomy.

Hsin Hong Kuo1, Yichieh Li1, Chin-Jung Wang1

  • 1Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital at Linkou, College of Medicine, Chang Gung University, Kwei-Shan, Tao-Yuan, Taiwan.

Taiwanese Journal of Obstetrics & Gynecology
|March 4, 2017
PubMed
Summary

The harmonic scalpel is a safe and effective alternative to conventional electrosurgery for laparoscopic myomectomy. While it reduces hospital stay, it incurs higher costs.

Keywords:
electrosurgeryfibroidharmoniclaparoscopymyomectomy

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Area of Science:

  • Gynecology
  • Minimally Invasive Surgery
  • Surgical Technology

Background:

  • Symptomatic uterine fibroids affect numerous women.
  • Laparoscopic myomectomy (LM) is a common surgical approach.
  • Comparing surgical tools is crucial for optimizing patient outcomes.

Purpose of the Study:

  • To compare the safety and effectiveness of the harmonic scalpel versus conventional electrosurgery in laparoscopic myomectomy.
  • Evaluate key outcomes including blood loss, operative time, and hospital stay.

Main Methods:

  • Retrospective chart review of 591 women undergoing LM.
  • Comparison of 33 cases using harmonic scalpel (LMH) against a matched control group using conventional electrosurgery (LME).
  • Analysis of blood loss, transfusion rates, operative time, cost, and hospital stay.

Main Results:

  • No cases required conversion to abdominal laparotomy.
  • Harmonic scalpel group showed significantly shorter postoperative hospital stays (2.0 vs. 2.5 days).
  • Hospital charges were significantly higher for the harmonic scalpel group (39,207.7 vs. 24,078.4 NTD).
  • No significant differences in operative length, blood loss, or transfusion requirements were observed.
  • Four minor complications occurred in the conventional electrosurgery group.

Conclusions:

  • Harmonic scalpel is as safe and effective as conventional electrosurgery for LM.
  • It offers a reduced postoperative hospital stay as an advantage.
  • Higher associated costs are a disadvantage compared to conventional electrosurgery.