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Original ArticleOpen Access
Laparoscopic Hysterectomy Using Laparosonic Coagulating Shears: Experience of 15 Cases
Srisombut C 
,
Weerakiet S
,
Weerakiet S CHARTCHAI SRISOMBUT, M.D.*,
SAWAEK WEERAKIET, M.D.*
In conventional laparoscopic hysterectomy, adequate hemostasis is provided by bipolar
coagulation, staple, and suture. The Laparosonic Coagulating Shears (LCS) have been proven to
give both hemostasis and cutting. The objective of this study was to evaluate the efficacy of the
LCS for laparoscopic hysterectomy. Fifteen patients indicated for hysterectomy were enrolled for
laparoscopic hysterectomy using LCS. Each procedure was performed under general endotracheal
anesthesia. The LCS were operated at power level 1 though 5. All pedicles, blood vessels, and
tissues were coagulated and cut by LCS. The cardinal ligaments were cut and ligated transva-
ginally. The uterus was removed through the vagina. The operative finding, uterine volume and
weight, operative time, C0
2
volume, blood loss and hospital stay were recorded. Among the 15
cases, the indications were myoma uteri (7 cases), adenomyosis (6 cases) and adenomyosis with
endometriomas (2 cases). The mean volume of the uterus was 226.8 cm3 (range 77-399 cm3
)
and
mean weight was 188.8 g (range 85-320 g). Mean operative time was 171.6 min (range
114-210 min) and C0
2
loss was 313.8 liters (range 120-650 liters). Blood loss was 366.7 ml
(range 100-1,500 ml). LCS can be used for coagulation and cutting simultaneously. Minimal
charring and smoke was observed during operation. In general, the hospital stay was 3 days
(range 2-4 days), except for one case of recto-sigmoid injury and 2 cases of ureteric injury when
the hospital stay was 7, 10, and 12 days, respectively. The injuries occurred in cases with anatomic
distortion, profuse bleeding, and dense adhesion. LCS can be used as an alternative instrument
for coagulation and dissection. According to our experience, it produces less charring and smoke
compared to electrocoagulation. However, a high rate of complications were still encountered.
Key word
: Harmonic Scalpel, Laparoscopic Hysterectomy, Laparosonic Coagulating Shears
SAWAEK WEERAKIET, M.D.*
In conventional laparoscopic hysterectomy, adequate hemostasis is provided by bipolar
coagulation, staple, and suture. The Laparosonic Coagulating Shears (LCS) have been proven to
give both hemostasis and cutting. The objective of this study was to evaluate the efficacy of the
LCS for laparoscopic hysterectomy. Fifteen patients indicated for hysterectomy were enrolled for
laparoscopic hysterectomy using LCS. Each procedure was performed under general endotracheal
anesthesia. The LCS were operated at power level 1 though 5. All pedicles, blood vessels, and
tissues were coagulated and cut by LCS. The cardinal ligaments were cut and ligated transva-
ginally. The uterus was removed through the vagina. The operative finding, uterine volume and
weight, operative time, C0
2
volume, blood loss and hospital stay were recorded. Among the 15
cases, the indications were myoma uteri (7 cases), adenomyosis (6 cases) and adenomyosis with
endometriomas (2 cases). The mean volume of the uterus was 226.8 cm3 (range 77-399 cm3
)
and
mean weight was 188.8 g (range 85-320 g). Mean operative time was 171.6 min (range
114-210 min) and C0
2
loss was 313.8 liters (range 120-650 liters). Blood loss was 366.7 ml
(range 100-1,500 ml). LCS can be used for coagulation and cutting simultaneously. Minimal
charring and smoke was observed during operation. In general, the hospital stay was 3 days
(range 2-4 days), except for one case of recto-sigmoid injury and 2 cases of ureteric injury when
the hospital stay was 7, 10, and 12 days, respectively. The injuries occurred in cases with anatomic
distortion, profuse bleeding, and dense adhesion. LCS can be used as an alternative instrument
for coagulation and dissection. According to our experience, it produces less charring and smoke
compared to electrocoagulation. However, a high rate of complications were still encountered.
Key word
: Harmonic Scalpel, Laparoscopic Hysterectomy, Laparosonic Coagulating Shears
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