Efficacy of using electrosurgical bipolar vessel sealing during vaginal hysterectomy in patients with different degrees of operative difficulty: a randomised controlled trial.

Objective: To assess the efficacy of electrosurgical bipolar vessel sealing using the LigaSure system during vaginal hysterectomy in comparison with conventional suture ligation method.

Study Design: 103 patients undergoing vaginal hysterectomy for benign conditions were randomised to either LigaSure or Suture groups. Each group was divided into two subgroups according to the degree of surgical difficulty.

Results: Participants in the LigaSure had shorter procedure time (52.5 min vs. 90 min; p<0.001) and less blood loss (230 ml vs. 360 ml; p<0.001). Complication rates were not statistically different between the two groups. The advantage of the LigaSure system in reducing the operative blood loss was more pronounced in the more difficult procedures.

Conclusion: The LigaSure system reduces the operating time (by reducing pedicle-securing time) and blood loss without increasing the post-operative complication rates of vaginal hysterectomy. This beneficial effect was found to be more pronounced in difficult procedures.