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Perioperative outcomes using LigaSure compared with conventional technique in peripartum hysterectomy

  • Aurianne Lauroy
  • Caroline Verhaeghe
  • Fabien Vidal
  • Olivier Parant
  • Guillaume Legendre
  • Paul GuerbyEmail author
General Gynecology
  • 21 Downloads

Abstract

Objective

To evaluate the use of new bipolar vessel sealing system like LigaSure™ compared to the standard surgical technique (suture) during emergency peripartum hysterectomy (EPH).

Methods

A retrospective observational bicentric study was conducted from February 2005 to August 2018 in the maternity wards of the University Hospital of Toulouse and Angers. All EPHs performed up to 24 h after delivery were included. The main outcome was the total blood loss. Secondary outcomes were operating time, number of blood transfusions, per and postoperative complications. A subgroup analysis was performed between hysterectomies performed in emergency and scheduled hysterectomies.

Results

Among 111,266 deliveries, 86 women (0.07%) underwent EPH, 29 were operated upon with LigaSure™, 57 with the traditional technique. In the LigaSure™ arm, there were statistically lower blood loss (3198 mL vs 4223 mL, p = 0.02), fewer blood transfusions (62.1% vs 94.7%, p = 0.0003, confirmed in subgroup analysis), and fewer perioperative complications (8.3% vs 45.5%, p = 0.04) for scheduled hysterectomies.

Conclusion

Bipolar vessel sealing systems such as LigaSure™ are a surgical instrument, easy to use for the surgeon, with an interest in the management of EPH, particularly for total blood loss, transfusions, and intraoperative complications.

Keywords

Emergency peripartum hysterectomy Postpartum hemorrhage Surgical technique 

Abbreviations

EPH

Emergency peripartum hysterectomy

PPH

Postpartum hemorrhage

Notes

Author's contribution

AL and PG had the idea for the original cohort study and, with FV, OP, GL carried out the design of the study. AL and CV collected the data, AL and PG analyzed/interpreted the data and produced the first draft. PG, AL and FV carried out statistical analysis. All authors read, revised and approved the submitted version of the manuscript.

Funding

All the authors report neither funding nor financial support for this study.

Compliance with ethical standards

Conflict of interest

All the authors report neither disclosure nor conflict of interest.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Obstetrics and GynecologyPaule de Viguier Hospital, CHU ToulouseToulouseFrance
  2. 2.Department of Gynecology-ObstetricsCHU AngersAngers CedexFrance
  3. 3.University Paul Sabatier Toulouse IIIToulouseFrance

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