Harmonic Shears Versus Conventional Suture in Abdominal Hysterectomy

Objective: The aim of this study was to compare the blood loss and operative time of abdominal hysterectomy using Harmonic Shears (HS) versus using conventional sutures.Methods: We randomized 60 patients scheduled for abdominal hysterectomy into two equal groups, 30 patients each. Ultrasonic vessel sealer (The Ultracision System: UltraCision® harmonic scalpel, Smithfield, RI) was used as the method of hemostasis in one group, while conventional sutures was the hemostasis technique in the other group. Procedure time was defined as time from initial skin incision to closure of the skin wound. Blood loss was estimated by the anesthesia service. Statistical methodology included the Student t and Mann-Whiteney’s U tests, and all comparisons were two tailed, with p 0.05 considered significant.Results: The mean procedure time in the Ultracision vessel sealer group was 40.3 minutes (range 30–95) versus 55.6 minutes (range 40–160) for the suture group (p=0.003). Mean estimated blood loss was also statistically less with Ultracision vessel sealer group: 74.9mL (range 30–250) versus 139.4ml (range 50–650) for the suture group (p=0.005). There was no significant difference in complication in both techniques.Conclusion: Ultrasonic vessel sealer seems to provide significant reduction in reduced operation time and blood loss. It could be an effective alternative to conventional sutures in abdominal hysterectomy. Further studies on larger number of patients are needed for a more solid evidence.