Electrocoagulation versus the Endo GIA in LAVH

We compared the operating room time using bipolar electrocoagulation and Endo GIA staples in 11 women undergoing laparoscopic-assisted vaginal hysterectomy (LAVH). Electrocoagulation was used on one side of the uterine pedicles and the Endo GIA stapling device on the contralateral pedicles. Each patient was randomized to the method used on each side and which method was used first. All procedures were symmetric, with or without bilateral salpingo-oophorectomy. Data were compared using the paired t test. Normal distribution was assessed by the Shapiro-Wilks test and the K-S (Lilliefors) test. The mean (± SD) procedure times for electrocoagulation and Endo GIA were 13.03 ± 1.34 minutes and 4.4 ± 0.33 minutes, respectively. This resulted in a mean difference of 8.66 ± 3.62 minutes (p <0.001). Patients requiring longer electrocoagulation times also required longer Endo GIA stapling times (p = 0.034). The Endo GIA stapling device required significantly less time to perform LAVH compared with electrocoagulation. The difference of 8.66 minutes, if multiplied by 2 (to account for a bilateral procedure), may or may not be clinically or economically significant, depending on hospital costs and charges for instruments, operating room time, and anesthesia.