Our Summary

The study looked at two tools used in a type of surgery called total laparoscopic hysterectomy, which is a minimally invasive procedure to remove the uterus. One tool is a more traditional device called Robi forceps, and the other is a more advanced tool called LigaSure. They compared outcomes for 101 women who had this surgery at a hospital, 37 of whom had the surgery with the Robi forceps and 64 with the LigaSure.

They looked at things like how old the patients were, how long the surgery took, how much blood they lost, how long they stayed in the hospital, and other measures of how well they did after surgery.

The two groups of patients were very similar in age, body mass index, whether they’d had children, whether they’d had previous pelvic surgery, and why they were having the hysterectomy. The surgeries with the Robi forceps took a little longer and there was a little more blood loss and a slightly larger drop in hemoglobin (a protein in your blood that carries oxygen), but these differences were small and could have been due to chance.

The researchers conclude that the traditional Robi forceps are just as safe and effective as the more advanced LigaSure for total laparoscopic hysterectomy. This could be good news for hospitals that can’t afford the more expensive LigaSure, as they can still offer a safe and effective surgery with the Robi forceps.

FAQs

  1. What were the primary objectives of this study on total laparoscopic hysterectomy?
  2. How do the outcomes of using conventional bipolar instruments compare to advanced bipolar instruments in total laparoscopic hysterectomy?
  3. Can a conventional bipolar system be considered a safe and effective alternative to LigaSure for total laparoscopic hysterectomy?

Doctor’s Tip

A helpful tip a doctor might tell a patient about laparoscopic hysterectomy is to discuss with them the type of bipolar energy instrument that will be used during the procedure. In this study, it was found that both conventional bipolar forceps and advanced bipolar instruments (such as LigaSure) were equally safe and effective for TLH. Patients can feel reassured knowing that both options are viable and can discuss any concerns or preferences with their healthcare provider.

Suitable For

Patients who are typically recommended for laparoscopic hysterectomy include those with benign gynecological disorders such as fibroids, abnormal uterine bleeding, endometriosis, and pelvic pain. Additionally, patients with a desire for minimally invasive surgery, shorter recovery time, and less scarring may also be good candidates for laparoscopic hysterectomy. It is important for patients to discuss their individual medical history and conditions with their healthcare provider to determine if laparoscopic hysterectomy is the right treatment option for them.

Timeline

Before laparoscopic hysterectomy:

  • Patient consults with a gynecologist and discusses the need for a hysterectomy
  • Pre-operative tests and evaluations are conducted to assess the patient’s overall health and suitability for surgery
  • Patient may undergo counseling to discuss the potential risks and benefits of the procedure
  • Surgical date is scheduled and patient is instructed on pre-operative preparations such as fasting and medication adjustments

After laparoscopic hysterectomy:

  • Patient is monitored in the recovery room immediately following surgery
  • Pain management and post-operative care instructions are provided
  • Patient may stay in the hospital for a day or two for observation and recovery
  • Follow-up appointments are scheduled to monitor healing and address any concerns
  • Patient gradually resumes normal activities and may experience improvements in symptoms related to their gynecological condition

What to Ask Your Doctor

Some questions a patient should ask their doctor about laparoscopic hysterectomy include:

  1. What are the potential risks and complications associated with a laparoscopic hysterectomy?
  2. How long will the procedure take and how long is the recovery time?
  3. Will I need to stay in the hospital overnight after the surgery?
  4. What type of anesthesia will be used during the procedure?
  5. How will my pain be managed after the surgery?
  6. Will I still be able to have children after a laparoscopic hysterectomy?
  7. What are the potential long-term effects of having a hysterectomy?
  8. Are there any alternative treatments or procedures that I should consider before opting for a hysterectomy?
  9. How many laparoscopic hysterectomies have you performed, and what is your success rate?
  10. What type of instruments and techniques will be used during the procedure, and how do they compare to other options available?

Reference

Authors: Yalcin Y, Yalcin SE. Journal: Ginekol Pol. 2019;90(11):640-644. doi: 10.5603/GP.2019.0112. PMID: 31802464