A COMPARISON OF THE USE OF LIGASURE AND HARMONIC DEVICES IN PLACENTA PERCRETA HYSTERECTOMIES: A RETROSPECTIVE COHORT STUDY

Zeyneb Bakacak MD, Murat Bakacak MD*, Kadir Güzin MD and Aytekin Uzkar MD

ABSTRACT

Aim: Caesarean hysterectomies performed in placenta percreta cases are procedures that can cause intense bleeding. New-generation vascular sealing systems are systems which can cut and seal at the same time, for which the field of use has expanded in recent years. The aim of this study was to make a retrospective study of hysterectomies performed using LigaSure (LS) and ultrasonic Harmonic (HS) devices. Material and Method: Placenta percreta cases with elective caesarean hysterectomy performed by the same surgeon were retrospectively screened. The cases were separated as the Harmonic group (Group 1) where HS devices were used in hysterectomies, and the LigaSure group (Group 2) where the LS device was used. The cases were compared in respect of demographic characteristics, operating time, number of transfused blood product units during the operation and in total, and the total amount of fluid in the abdominal drain. Results: Demographic data were similar in both groups. The operating time was found to be signifcantly shorter in the LS group (p<0.001). The number of intraoperative transfused erythrocyte suspension units (ES), the total number of transfused ES, and the total units of transfused fresh frozen plasma (FFP) were found to be statistically significantly higher in the HS group than in the LS group (p:0.031, p:0.022, p:0.024, respectively). Conclusion: When compared with LS devices in caesarean hysterectomies applied to placenta percreta cases, HS was determined to be a system providing less successful hemostasis and leading to greater bleeding. Therefore, this system was not seen to be appropriate for use in this type of surgery.

Keywords: Placenta percreta; caesarean hysterectomy; ligasure; harmonic scalpel.