Electrosurgical bipolar vessel sealing versus conventional clamping and suturing for total abdominal hysterectomy

Objectives: To compare the use of Electrosurgical bipolar vessel sealing LigaSure™ small jaw instrument (LSJI) with conventional suture ligation in total abdominal hysterectomy (TAH). Methods: In this retrospective study 80 patients who underwent hysterectomy in the Gynecology and Obstetrics Department of Gulhane Education and Research Hospital between April 2017 and August 2018 were included. Two different groups that underwent Electrosurgical bipolar vessel sealing LigaSure™ small jaw instrument (LSJI) and conventional suture ligation in hysterectomy operation were analyzed retrospectively. The parameters evaluated and compared between the two groups include operation time, intraoperative blood loss, duration of hospitalization and incision length. Results: Among the parameters we compared between the two groups, there was no statistically significant difference between the amount of intraoperative blood loss (p:0.68) and the incision length (p:0.65). Among the parameters we compared between the two groups, a statistically significant difference was observed between the operation time (p:0.016) and the duration of hospitalization (p:0.01). Conclusion: Our comparison of LSJI vs. conventional ligation in hysterectomy revealed a significant difference only in operative time, where surgeries involving conventional ligation were shorter. On the other hand, incision length was evaluated in our study which has not been addressed in previous studies. There is also a need for multi-center studies that include more patients and evaluate cost-effectiveness. doi: https://doi.org/10.12669/pjms.38.1.4197 How to cite this:Ulubay M, Kinci MF, Pay RE, Dede M. Electrosurgical bipolar vessel sealing versus conventional clamping and suturing for total abdominal hysterectomy. Pak J Med Sci. 2022;38(1):---------. doi: https://doi.org/10.12669/pjms.38.1.4197 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Use of a Bipolar Vessel-Sealing Device for Splenic Parenchymal Resection in Three Dogs and One Cat

ABSTRACT Based on splenic abnormalities noted during surgery, four client-owned animals (three dogs, one cat) undergoing exploratory laparotomy were identified as candidates for partial splenectomy. In three cases, small mass lesions of the spleen were identified on elective exploratory laparotomy. In one case, the patient was referred for emergency surgery for diaphragmatic hernia with entrapment of stomach and spleen. The discovery of avulsion of a significant portion of the splenic mesentery led to the decision to perform partial splenectomy in this case. All animals included in the study underwent partial splenectomy by one of two board-certified veterinary surgeons at a multispecialty hospital between 2014 and 2018. The same type of bipolar vessel-sealing device was used in each surgery, and three of four partial splenectomy cases recovered uneventfully. One patient went into cardiopulmonary arrest hours after surgery and died; however, this is not suspected to be due to the described partial splenectomy technique. The bipolar vessel-sealing device is suitable for use in resection of the splenic parenchyma in some canine and feline patients. This technique is designed to decrease surgical time, provide effective hemostasis, and preserve the important functions of the spleen that are lost when total splenectomy is undertaken.

Minilaparotomy hysterectomy Versus laparoscopic hysterectomy for benign uterine lesions A Comparative study

Background: Hysterectomy is world wide's second most commonly done gynecological surgery, second only to the caesarean section. There is no general consensus, however, about the optimal hysterectomy process. Hysterectomy may be achieved through different techniques such as stomach, vaginal and laparoscopic. The goal of the study is to explore whether the hysterectomy of minilaparotomy for benign uterine lesions may be a viable option to laparoscopic hysterectomy in terms of short-term operational and postoperative performance. Methods: 105 patients who were due to undergo complete hysterectomy for a benign uterine lesion were split into 3 categories according to their preference of therapeutic therapy method: group A (35 patients) minilaparotomy hysterectomy utilizing traditional sutures. Group B (35 patients) minilaparotomy hysterectomy utilizing bipolar vessel sealing procedure (Ligasure). Group C (35patients) laparoscopic hysterectomy using Ligasure. Result (s): The operating time in Group A (84.71 ± 9.91 minutes), group B (55.31 ± 7.81 minutes), while group C (94.81 ± 16.1 minutes).The duration until resumption of intestinal sounds in group C (12.31 ± 2.51 hours) in comparison to group A (17.41 ± 1.91 hours) and group B (16.51 ± 1.761 hours). Blood loss in group B (99.11 ± 30.81 ml), group A (130.31 ± 54.41 ml) and group C (136.61 ± 6.61 ml). The longest hospital stay occurred in group A (31.8 1± 5.71 hours) versus groups B (20.71 ± 2.51 hours) and C (19.31 ± 6.1 hours). The highest pain score was observed in group A (5.21 ± 1.11) versus groups B (3.81 ± 1.61) and C (3.71 ± 1.21). There was no significant difference in the incidence of intraoperative or postoperative complications. Conclusion (s): Less operational time and intraoperative blood loss were correlated with the usage of ligasure bipolar vessel sealing device in minilaparotomy hysterectomy, whereas it was comparable to laparoscopic hysterectomy in hospital stay and low morbidity postoperative pain scoring and a limited hospital stay. It can be an acceptable alternative to laparoscopic hysterectomy, suitable in areas without laparoscopic experience or facilities.

The endoscopic no-touch saphenous vein harvesting technique

The no-touch saphenous vein harvesting technique is being increasingly used; however, this technique causes more leg wound complications than conventional techniques. Endoscopic saphenous vein harvesting is considered a safe and effective approach for reducing leg complications, despite the fact that experience with this technique remains limited, because leg CO2 insufflation and dissection with a tip cannula to isolate the vein enables the graft to naturally skeletonize. In this video tutorial, we demonstrate our endoscopic no-touch saphenous vein harvesting technique using a reusable saphenous vein retractor system without CO2 insufflation and an electrothermal bipolar vessel sealing device.