An Analytical Study of Use of BiClamp and Sutures in Vaginal Hysterectomy in Tertiary Care Hospital

Abstract Background: Vaginal hysterectomy traditionally uses sutures for hemostasis, which is time-consuming and technically demanding. Energy-based vessel sealers like BiClamp offer potential advantages including reduced operative time, blood loss, and improved surgical outcomes in gynecological procedures. Objectives: To evaluate efficacy and safety of BiClamp versus conventional sutures in vaginal hysterectomy, comparing intraoperative outcomes, postoperative complications, pain scores, and hospital stay duration in tertiary care setting. Methodology: This prospective observational study conducted over 12 months included 72 patients undergoing vaginal hysterectomy, randomly divided into BiClamp (n=36) and conventional sutures (n=36) groups. Patients with advanced malignancy, uterus >12 weeks, and previous pelvic surgeries were excluded. Primary outcomes measured included operative time, blood loss, complications, pain scores using VAS, and hospital stay. Statistical analysis performed using SPSS with p<0.05 considered significant. Results: BiClamp group showed significantly shorter operative time (36.7±8.9 vs 66.9±10.9 minutes, p<0.001) and reduced blood loss (85.7±20.4 vs 158.6±29.2 ml, p<0.001). Postoperative complications were lower in BiClamp group: no fever versus 11.1% (p=0.040), no wound infection versus 16.7% (p=0.011), and no urinary retention versus 8.3% (p=0.077). VAS pain scores were significantly lower at all postoperative days (p<0.001). Hospital stay was shorter in BiClamp group (3.6±0.6 vs 7.6±3.6 days, p<0.001). However, labial burns occurred in 13.9% of BiClamp patients versus none in conventional group (p=0.020). No major complications like bladder or bowel injuries occurred in BiClamp group compared to 8.3% and 2.8% respectively in conventional group. Conclusion: BiClamp demonstrates superior clinical outcomes with shorter operative time, reduced blood loss, fewer postoperative complications, and faster recovery compared to conventional sutures in vaginal hysterectomy procedures.