Comparative Study of Bipolar Vessel Sealing Against Standard Suturing in Total Abdominal Hysterectomy

Background and Purpose: Laser, electrothermal, and ultrasonic coagulation techniques are now preferred in hysterectomy procedures, replacing traditional sutures. The study aims to compare the differences in the postoperative complications and the efficacy of the electrosurgical bipolar vascular sealing system (BVSS) and conventional suture ligatures. Materials and Methods: In a prospective study, women referred for total abdominal hysterectomy (TAH) due to different benign causes were randomized to the BVSS group (n=28) or the conventional suture ligature TAH group (n=24). The main outcome indicators included duration of operative time, blood loss, pain level, hospital stay, as well as complications of operation.Results: The results showed that the BVSS approach was associated with less blood loss during surgery (P=0.0008), lower reduction in hemoglobin levels after surgery (P<0.0001), and short duration of operative time (P=0.0400). Both groups exhibited similar outcomes in terms of drainage volume, postoperative fever, incision length, and duration of hospital stay, with no significant differences observed. Regarding pain scores, the conventional surgery group had lower levels of postoperative pain within 24 hours compared to the BVSS group (P= 0.0230), without significant differences throughout the next 48 hours.Conclusions: Bipolar vascular sealing reduces blood loss and operation time in abdominal hysterectomy for benign diseases. Further research with larger patient populations is needed to assess other postoperative complications and cost-effectiveness.