Vaginal hysterectomy and multimodal anaesthesia with bipolar vessel sailing (Biclamp® forceps) versus conventional suture technique: quality results’ analysis
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The medical and economic benefits of the transvaginal approach over the abdominal and laparoscopic methods are demonstrated in many studies. Vaginal hysterectomy with bipolar vessel sailing (BiClamp®) represents an example of mininvasive surgery and could be a valid and cost-benefit alternative in the surgical treatment of benign gynaecologic disease. BiClamp® may be carried out according to Clavè’s technique with a good result in postoperative pain.
Prospective randomized study (Canadian Task Force classification I). We compared the vaginal hysterectomy with salpingo-oophorectomies with BiClamp® and multimodal anaesthesia (group A 30 patients) with vaginal hysterectomy with salpingo-oophorectomies and spinal anaesthesia (group B 30 patients).
The median operating time was 33.5 min for group A and 54.5 min for group B (p < 0.0001). The median blood loss was 59.25 ml in group A and 81.75 ml in group B. The median hospital stay was 1.6 ± 0.58 days for group A and 2.55 ± 0.66 days for group B. Postoperative pain was statistically different between groups in the immediate postoperatory times, at 2 and at 6 h from the surgery and at 10 p.m. (p < 0.0001). Analyses of cost-effectiveness have stated advantages in terms of costs and indirect–direct benefits but also in earlier resumption of working.
BiClamp® technique with multimodal anaesthesia has advantages from surgical, anaesthesiology and economic point of view. It is a minimally invasive surgery characterised by lower morbidity, quicker surgery times and reduced costs when compared to classical vaginal hysterectomy. BiClamp® technique represents a new border in vaginal surgery.
KeywordsBipolar vessel sailing BiClamp® Vaginal hysterectomy Mininvasive surgery Multimodal anesthesia
Conflict of interest
The authors certify that no actual or potential conflict of interest exist in relation to this article.
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