Comparison the efficacy of laparosonic coagulating shears and electrosurgery in laparoscopically assisted vaginal hysterectomy: preliminary results

Objective: To compare the safety and effectiveness of laparosonic coagulati ng shears (LCS) and electrosurgery for use in laparoscopically assisted vag inal hysterectomy (LAVH). Study design: In this prospective study, patients undergoing LAVH performed by one of the authors from October 1997 to January 1998 were assigned at r andom to the electrosurgery group (n = 20) or the LCS group (n = 20). Proce dures performed with LCS or electrosurgery included coagulation and separat ion of infundibulopelvic or utero-ovarian round ligaments, vesico-uterine-v isceral peritoneal fold dissection, and anterior and posterior colpotomy. O utcome measures were operative time, blood loss, decrease in hemoglobin val ues, and length of hospitalization. Results: The mean operative time (90 +/- 22.9 min versus 80.3 +/- 17.1 min, P = 0.391), blood loss (308 +/- 167 mi versus 250 +/- 104 mi, P = 0.11), a nd hemoglobin decrease (1.57 +/- 0.769 mg/dl versus 1.36 +/- 0.886 mg/dl, P = 0.55) were slightly greater in the LCS group than in the electrosurgery group, although these differences were not statistically significant. The l ength of hospital stay was similar in the two groups (5 days). No patients developed serious complications related to electrosurgery or LCS. Conclusion: Our findings indicate that LCS is as safe and effective as elec trosurgery, and may offer an alternative option for patients undergoing LAV H.