Electrosurgical Bipolar Vessel Sealing Versus Conventional Clamping and Suturing for Total Abdominal Hysterectomy: A Randomized Trial

Study ObjectiveTo compare the effects of bipolar vessel sealing versus conventional clamping and suturing in women undergoing total abdominal hysterectomy.DesignA randomized controlled trial was performed. Patients were randomized to vessel sealing or conventional surgery. Postoperative pain was the primary outcome. An intention-to-treat analysis was performed (Canadian Task Force classification I).SettingTwo Dutch teaching hospitals.PatientsA total of 57 women undergoing abdominal hysterectomy for benign conditions.Measurements and Main ResultsDuring the first 3 postoperative days, patients operated on using vessel sealing had statistically significantly lower pain scores. The amount of blood loss, surgery time, complication risk, and duration of hospitalization were similar between both groups. Patients in the vessel-sealing group resumed their normal daily activities on average 8 days earlier as compared with the conventional group. Postoperative pelvic floor function was similar in both groups.ConclusionThe use of vessel sealing during abdominal hysterectomy for benign conditions appears to be associated with reduced postoperative pain and faster recovery.