World Journal of Laparoscopic Surgery

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VOLUME 14 , ISSUE 1 ( January-April, 2021 ) > List of Articles

Original Article

Efficacy and Safety of Electrothermal Bipolar Vessel Sealer vs ENSEAL in Total Laparoscopic Hysterectomy for Large Uterus: A Comparative Study in Mysuru, South India

Prathap Talwar, Swathi Hassan Kumarachar, Lakshmi Velayudam, Tohreen Fathima

Keywords : Electrothermal vessel sealers, ENSEAL, Laparoscopic hysterectomy, Large uterus

Citation Information : Talwar P, Kumarachar SH, Velayudam L, Fathima T. Efficacy and Safety of Electrothermal Bipolar Vessel Sealer vs ENSEAL in Total Laparoscopic Hysterectomy for Large Uterus: A Comparative Study in Mysuru, South India. World J Lap Surg 2021; 14 (1):5-9.

DOI: 10.5005/jp-journals-10033-1431

License: CC BY-NC 4.0

Published Online: 00-04-2021

Copyright Statement:  Copyright © 2021; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Context: Hysterectomy is the most commonly performed gynecological procedure around the world. Hemostasis is of major concern in an enlarged uterus as chances of hemorrhage are more. New laparoscopic vessel sealing devices have been developed for laparoscopic tissue dissection and vessel sealing. In this study, an ALAN vessel sealer, an indigenous electrothermal bipolar vessel sealing device, is compared with ENSEAL device with respect to safety, efficacy, and perioperative outcomes in laparoscopic hysterectomy for a large uterus. Aims and objectives: This study aimed to determine the efficacy and safety of electrothermal bipolar vessel sealer (ALAN vessel sealer) vs ENSEAL in total laparoscopic hysterectomy (TLH) for a large uterus. Materials and methods: This prospective randomized case–control study included 100 women who underwent TLH for a large fibroid uterus. Of them, 50 women underwent TLH using ALAN vessel sealer, and the remaining 50 using ENSEAL. Efficacy, safety, and perioperative outcomes of both the groups were compared. Statistical analysis: Statistical analysis was done using SPSS version 16.0 software. For evaluating continuous variables and discrete variables, independent T-tests, and Chi-square tests, respectively, were used. Results: Duration of surgery in ALAN vessel sealer group was 56.90 ± 12.45 minutes and in ENSEAL group was 57.25 ± 13.54 minutes (p = 0.9) and mean blood loss in group A and group B was 111.40 ± 22.32 and 107.84 ± 20.33 mL, respectively ( p = 0.4), both of the data were not statistically significant. No significant differences were noticed in the demographic characteristics, intraoperative, and postoperative complications between the two groups. Conclusions: The ALAN vessel sealer is safe and as efficient as ENSEAL in decreasing blood loss and operative time when laparoscopic hysterectomy is performed for an enlarged uterus. It is cost-effective and a promising instrument for TLH in developing countries.


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  1. Sinha R, Sundaram M, Lakhotia S, Mahajan C, Manaktala G, Shah P. Total laparoscopic hysterectomy for large uterus. J Gynecol Endosc Surg 2009;1(1):34–39. DOI: 10.4103/0974-1216.51908.
  2. Uccella S, Cromi A, Serati M, Casarin J, Sturla D, Ghezzi F. Laparoscopic hysterectomy in case of uteri weighing ≥1 kilogram: a series of 71 cases and review of the literature. J Minim Invasive Gynecol 2014;21(3):460–465. DOI: 10.1016/j.jmig.2013.08.706.
  3. Rothmund R, Kraemer B, Bricker S, Taran FA, Wallwiener M, Zubke A, et al. Laparoscopic supracervical hysterectomy using ENSEAL vs standard bipolar coagulation technique: randomized controlled trial. JMIG 2013;20(5):661–666. DOI: 10.1016/j.jmig.2013.04.014.
  4. Hasanov M, Denschlag D, Seemann E, Gitsch G, Woll J, Klar M. Bipolar vessel-sealing devices in laparoscopic hysterectomies: a multicenter randomized controlled clinical trial. Arch Gynecol Obstet 2018;297(2):409–414. DOI: 10.1007/s00404-017-4599-y.
  5. Garry R, Fountain J, Brown J, Manca A, Mason S, Sculpher M, et al. EVALUATE hysterectomy trial: a multicentre randomised trial comparing abdominal, vaginal and laparoscopic methods of hysterectomy. Health Technol Assess 2004;8(26):1–154. DOI: 10.3310/hta8260.
  6. Phipps JH. Thermometry studies with bipolar diathermy during hysterectomy. Gynaecol Endosc 1994;3:5–7.
  7. Aytan H, Nazik H, Narin R, Api M, Tok EC. Comparison of the use of LigaSure, Halo PKS cutting forceps and ENSEAL tissue sealer in total laparoscopic hysterectomy: a randomized trial. J Minim Invasive Gynecol 2014;21(4):650–655. DOI: 10.1016/j.jmig.2014.01.010.
  8. Bicer M, Guner Z, Karas C, Guclu A, Gol M. Using LigaSure vessel sealing device in the large uterus at laparoscopic hysterectomy. Clin Exp Obstet Gynecol 2016;43(6):880–882. PMID: 29944243.
  9. Aykan YB, Karadag B, Mulayim B. Comparison of the efficacy and safety of two advanced vessel sealing technologies in total laparoscopic hysterectomy. J Obstet Gynaecol Res 2019;45(11):2220–2227. DOI: 10.1111/jog.14096.
  10. Kondo W, Bourdel N, Marengo F, Botchorishvili R, Pouly JL, Jardon K, et al. Is laparoscopic hysterectomy feasible for uteri larger than 1000 g? Eur J Obstet Gynecol Reprod Biol 2011;158(1):76–81. DOI: 10.1016/j.ejogrb.2011.03.027.
  11. Glaser LM, Milad MP. Bowel and bladder injury repair and follow-up after gynecologic surgery. Obstet Gynecol 2019;133(2):313–322. DOI: 10.1097/AOG.0000000000003067.
  12. Paul PG, Panditrao AS, Khan S, Talwar P, Kaur H, Barsagade S. Secondary hemorrhage after different modes of hysterectomy. Gynecol Surg 2013;10:267–272. DOI: 10.1007/s10397-013-0811-7.
  13. Paul PG, Prathap T, Kaur H, Shabnam K, Kandhari D, Chopade G. Secondary hemorrhage after total laparoscopic hysterectomy. JSLS 2014;18(3):e2014.00139. DOI: 10.4293/JSLS.2014.00139.
  14. Hur HC, Guido RS, Mansuria SM, Hacker MR, Sanfilippo JS, Lee TT. Incidence and patient characteristics of vaginal cuff dehiscence after different modes of hysterectomies. J Minim Invasive Gynecol 2007;14:311–317. DOI: 10.1016/j.jmig.2006.11.005.
  15. Katherine OH, McCutcheon SP, McCutcheon JG. Laparoscopic hysterectomy: impact of uterine size. J Minim Invasive Gynecol 2011;18(1):85–91. DOI: 10.1016/j.jmig.2010.09.016.
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