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

Objective: 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. Study design: 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. Results: 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 +/- 0.9 h vs. 33.2 +/- 1.7 h; 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. Conclusion: 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. (C) 2009 Elsevier Ireland Ltd. All rights reserved.