Comparison of Conventional Suture versus Electrosurgical Bipolar Vessel Sealing in Abdominal Hysterectomy: A randomized Control Trial

บทคัดย่อ

              Electrosurgical bipolar vessel sealing has been used in many fields of surgery. This presented trial was randomized controlled trial comparing the effects of conventional suturing and electrosurgical bipolar vessel sealing (BiClamp) in women undergoing abdominal hysterectomy for benign conditions.
Sixty patients undergoing abdominal hysterectomy (with or without salpingo-oopherectomy) for benign conditions were performed. The patients were randomized to conventional suture (n = 30) or BiClamp (n = 30). Demographic data showed no statistical difference between the two groups. The mean operative time in conventional suture group was 92.3, SD26.54 minutes versus
70.03, SD 21.06 minutes for Biclamp group (p<0.001). Mean intraoperative blood loss in conventional suture group was 357, SD 245.34 ml versus 248.33, SD 154.52 ml for Biclamp group (p 0.04). The requirement of surgical sutures was highly significant lower in BiClamp group than in conventional suture group (mean 7.27 units versus 10.77 units, p<0.001). No significant differences in
number of blood transfusion units, length of hospital stay, perioperative and postoperative complications were found in both groups. Postoperative pain was no different between the two groups in the first 12 hours after surgery but highly significant lower in the BiClamp group than in the conventional suture group at 24 hours after surgery. In conclusion, EBVS is an expensive but convenient
instrument. The use of BiClamp in abdominal hysterectomy can reduce operative time, blood loss and postoperative pain,it allows faster but is equally safe compare with conventional suture ligature. Furthermore this procedure needs less suture materials that can overcome an expensive cost if used in the regional hospital that have high volume of patients.
Key words: BiClamp, abdominal hysterectomy, bipolar vessel sealing