Perioperative outcomes using LigaSure compared with conventional technique in peripartum hysterectomy
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To evaluate the use of new bipolar vessel sealing system like LigaSure™ compared to the standard surgical technique (suture) during emergency peripartum hysterectomy (EPH).
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.
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.
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.
KeywordsEmergency peripartum hysterectomy Postpartum hemorrhage Surgical technique
Emergency peripartum hysterectomy
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.
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.
- 17.Janssen PF, Brölmann HAM, van Kesteren PJM, Bongers MY, Thurkow AL, Heymans MW et al (2011) Perioperative outcomes using LigaSure compared with conventional bipolar instruments in laparoscopic hysterectomy: a randomised controlled trial. BJOG Int J Obstet Gynaecol 118(13):1568–1575CrossRefGoogle Scholar