Liga Sure combined with bipolar electric knife in laparoscopic hysterectomy for enormous uterus

Objective: To investigate the surgical techniques and safety of vessel sealing system( LigaSure) and bipolar electrosurgical generator in laparoscopic hysterectomy for enormous uterus. Methods: From Jan. 2008 to Dec. 2013,168 patients with uterine fibroids were selected for the study,all patients were treated with laparoscopic total hysterectomy. Surgical instruments were selected according to patients' wishes,and according to the surgical equipment used the 168 patients were divided into group A( n = 83,LigaSure and bipolar electric knife) and group B( n = 85,bipolar electrosurgical generator). Conversion to open surgery,operative time,blood loss,postoperative exhaust time,postoperative hospital stay,incidence of postoperative complications were compared between the two groups. Results: In group A the rate of conversion to laparotomy was 3. 6%,and 4. 7% in the group B,the difference was not statistically significant( P 0. 05). The operative time and blood loss of group A were less than those of group B( P 0. 05). The postoperative exhaust time and postoperative hospital stay of two groups was not statistically different( P 0. 05). In group A,1 patient with uterine adenomyosis was found mild extension of left fallopian tube,mild hydronephrosis of the left kidney within 1 week,after anti-inflammatory treatment of 2 weeks,this patient improved and was discharged. Patients in group B did not suffer from serious complications,the difference was not statistically significant( P 0. 05). Conclusions: Using LigaSure and bipolar electric knife in hysterectomy has shorter operative time,less blood loss,and the clinical efficacy is similar with simple use of bipolar electric knife,this procedure can promote the popularization of laparoscopic hysterectomy for enormous uterus.