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LigaSure vessel sealing system in vaginal hysterectomy: safety, efficacy and limitations

  • General Gynecology
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Purpose

The aim of this study is to compare vaginal hysterectomy performed with standard technique versus the one performed with LigaSure.

Methods

Observational-longitudinal-cohort study on 42 women candidates to vaginal hysterectomy because of benign uterine pathology. Outcome variables, methods of analysis, inclusion and exclusion criteria were determined prospectively. Eligible patients were subdivided in Group-A (LigaSure-21 patients), or in Group-B (classical-21 patients). Group-A was divided into Subgroup-A1 (10 patients) and Subgroup-A2 (11 patients), depending on the point where the stump of the uterosacral-ligament was transfixed: Subgroup-A1 at cervical portion, Subgroup-A2 at intermediate portion. For all patients were reported: pre-post surgery haemoglobin and hematocrit, number of sutures, duration of intervention and blood loss, NRS-score on first/third post-operative days. All patients underwent gynaecological examination 30 and 180 days after surgery.

Results

General characteristics did not show significant differences between the two groups. Statistically significant differences emerged from the comparison between Group-A versus Group-B in terms of: intraoperative bleeding, post-operative value of haemoglobin, Δ-Hb, number of sutures, surgical time, pain at first and third post-operative day. The 180 days follow-up demonstrated four cases of vaginal vault prolapse, only in the Subgroup-A1 related to thermal damage of the uterosacral ligament.

Conclusion

LigaSure vessel sealing system is a safe alternative for securing pedicles in vaginal hysterectomy with significant improvement in patients outcome. Following vaginal vault prolapse, we determined the optimal fixation-site to perform the colposuspension in the intermediate portion of the uterosacral-ligament, especially if the cervical portion received a thermal damage, as occurs during the LigaSure use.

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Acknowledgments

The authors thank all Gynaecologists who helped in collecting data. The Authors thank all Anaesthesiologists for their precious contribute in performing the study. All authors declare they have no funding.

Conflict of interest

All authors declare that they have no conflict of interest.

Author information

Authors and Affiliations

  1. Department of Woman and Child Health, University of Padua, Padua, Italy

    Salvatore Gizzo, Giorgia Burul, Stefania Di Gangi, Laura Lamparelli, Carlo Saccardi, Giovanni Battista Nardelli & Donato D’Antona

  2. UCL Institute for Women’s Health, University College London, London, UK

    Giorgia Burul

  3. Dipartimento della Salute della Donna e del Bambino, U.O.C. di Ginecologia e Ostetricia, Via Giustiniani 3, 35128, Padua, Italy

    Salvatore Gizzo

Authors
  1. Salvatore Gizzo
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  2. Giorgia Burul
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  3. Stefania Di Gangi
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  4. Laura Lamparelli
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  5. Carlo Saccardi
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  6. Giovanni Battista Nardelli
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  7. Donato D’Antona
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Correspondence to Salvatore Gizzo.

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Gizzo, S., Burul, G., Di Gangi, S. et al. LigaSure vessel sealing system in vaginal hysterectomy: safety, efficacy and limitations. Arch Gynecol Obstet 288, 1067–1074 (2013). https://doi.org/10.1007/s00404-013-2857-1

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  • DOI: https://doi.org/10.1007/s00404-013-2857-1

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