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Abstract
Introduction/Background Advanced bipolar technology devices are now routinely used for sealing and transecting blood vessels in many surgical specialties including gynecology. The main advantage is enhanced sealing capability, especially in blood vessels larger than 2 mm in diameter. These technologies are particularly efficient for the sealing of large vessels of up to 5–7 mm in diameter through compression and efficient energy delivery to the tissue. The aim of our study was comparison between the reusable traditional bipolar device and the disposable Caiman® 5 instrument, regarding the operating time in patients undergoing laparoscopic hysterectomies for various gynecological conditions.
Methodology We retrospectively recruited 51 patients who underwent laparoscopic hysterectomies in 2017 and compared them to 62 patients who underwent the same procedures in 2018. They were further divided in two groups regarding the type of hysterectomy performed, subtotal laparoscopic hysterectomy (SLH) or total laparoscopic hysterectomy (TLH). First group in our study underwent procedures in 2017. using traditional bipolar forceps jaws, while in second group laparoscopy was performed with Caiman® 5. The difference in operating time was investigated.
Results Results revealed considerable shorter operating time since introduction of avanced laparoscopic technology in our department (56.5 minutes ± 6.8 for SLH in 2017. using traditional bipolar device vs 42.1 minutes ± 5.8 using Caiman® 5 in 2018., p<0.0001) (figure 1.)
This beneficial effect appears more noticeable in more difficult procedures (110.7 minutes ± 8.5 for TLH in 2017. using traditional bipolar device vs 76.5 minutes ± 11.4 using Caiman® 5 in 2018., p<0.0001). (Figure 2.)
Conclusion In conclusion, we observed a significantly shorter operating time using Caiman® 5 than traditional bipolar device in both SLH and TLH. This difference was more pronounced in more complex procedure such as TLH. However, the main issue with this instruments is that they are disposable and represent significant financial burden.
Disclosure Nothing to disclose
Box plot diagram of of all measured durations of subtotal hysterectomies
Box plot diagram of of all measured durations of total hysterectomies