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Background vaginal hysterectomy (Transvaginal Hysterectomy, TVH) for nearly two hundred years of history, previously used only for patients with uterine prolapse, has been widely used in genital prolapse and indications for hysterectomy patients. In recent years, many reports TVH superiority compared with abdominal hysterectomy and laparoscopic hysterectomy has not open, gastrointestinal disturbance, shorter operative time, less blood loss, postoperative pain lighter, recovery fast, postoperative disease rate, shorter hospital stay, meet the most minimally invasive principles, especially for patients with severe abdominal obesity, solve surgical exposure difficult and postoperative abdominal incision recovery and poor, is expected to become full hysterectomy surgery. TVH relatively high level of clinical operations of the surgeon and surgical experience requirements, so that it can not carry out extensive. In recent years, with the development of vaginal surgical instruments and electric, many new surgical instruments used in clinical, largely improve the feasibility and safety of TVH further expand its indications. The bipolar vessel closure (Electrosurgical Bipolar Vessel Sealing, also known Ligasure) is a novel electrical surgical hemostatic way U.S. FDA approved 7mm within vascular tissue can be safely closed, the pressure by the high frequency power and vascular jaw the lumen closed organization, collagen and elastin dissolved the vessel wall and tissue degeneration, the formation of a permanent translucent and forceps-like terminal operating device and do not need to suture the advantages TVH operation easier and superior technology. The article will our hospital the application Ligasure and the traditional the suture method Enforcement TVH surgery clinical data of 60 patients were analyzed to compare the postoperative differences in TVH value. The purpose through the purposes of the application Ligasure traditional suture method TVH surgery 60 patients with clinical data statistical analysis, evaluation bipolar vessel sealing (Electrosurgical Bipolar Vessel Sealing, Ligasure) in vaginal hysterectomy (Transvaginal Hysterectomy, TVH) in value. Method 1. Retrospective analysis of our hospital from 2005.6 to 2006.8 during the line TVH 60 patients, which the application Ligasure group and traditional suture group 30 cases. 2. The general analysis of the age of the two groups of patients, BMI (body mass index, BMI = weight / height ~ 2), gravidity, parity, uterine volume and past pots abdominal surgery history compared to investigate the conditions of patients with vaginal surgery . 3. The two groups of patients, operative time, blood loss, adjacent organ injury incidence, conversion to open surgery the incidence of postoperative anal exhaust time, the highest postoperative body temperature, body temperature returned to normal time required TVH surgery postoperative analysis compared to explore Ligasure superiority in the TVH. 4. Ligasure group of patients with previous abdominal surgical history of positive and negative surgical time, blood loss, intraoperative and postoperative complications were analyzed and compared, to explore the history of previous abdominal surgery should be treated as TVH contraindications. 5. Statistical analysis: SPSS13.0 statistical package for statistical analysis. Χ ~ 2 test was used to compare the mean comparison t test, positive rate, test level of P <0.05 was significant difference. Results 1. Compared to the general the, Ligasure patients BMI (23.13 ± 2.08/21.3 ± 2.13, t = 3.36, P = 0.001), uterine volume [(7.50 ± 2.16/5.27 ± 1.8) weeks of gestation, t = 4.350, P = 0.000] increase statistically significant; patients age, gravidity, parity was no significant difference. Show that the increase of the vaginal surgery Ligasure patients condition more difficult than the suture group. 2. Postoperative compared the total operation time of the Ligasure group [(54.7 ± 18.77/66.73 ± 17.46) min, t = 2.571, P = 0.013] and blood loss [(59.67 ± 31.92/77.0 ± 22.84) ml The two groups of patients were not adjacent organ injury, the Ligasure group patients converted to laparotomy No statistically line. 3. Previous abdominal surgical history Ligasure group positive operative time and blood loss compared with the negative, not statistically significant, the history of previous abdominal surgery can not be considered TVH contraindications. Conclusion 1. Ligasure as a new type of electric surgical hemostasis devices, can be safely closed vascular tissue within the diameter of 7mm good clinical application security. 2. The be applied TVH, Ligasure shorten the operation time, improve postoperative. 3. Expand the the TVH indications has its unique advantages for patients with obesity, bulky uterus and past pots abdominal surgery vaginal surgery poor.
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