Comparative Analysis of Vaginal Cuff Dissection Outcomes in Laparoscopic Hysterectomy: Monopolar Hook vs. Harmonic Scalpel

Background and Aims: This study aimed to compare the outcomes of vaginal cuff separation using monopolar hook or harmonic scalpel in laparoscopic hysterectomy. Materials and Methods: A retrospective analysis was conducted on ۲۱۰ women who underwent laparoscopic hysterectomy between ۲۰۲۲ and ۲۰۲۴. A total of ۱۰۵ cases for each surgical method were randomly selected from patient records. Demographic and clinical data were extracted from medical records and analyzed using IBM SPSS version ۲۶. P-value < ۰.۰۵ was deemed as statistically significant. Results: The mean age in the harmonic and monopolar groups was ۲۴.۷۶ (±۵.۴۱) and ۲۵.۷۵ (±۴.۶۴) years, respectively. There were no statistically significant differences between the groups in terms of age, BMI, hospitalization, history of previous abdominal surgery, preoperative hemoglobin levels, and hormone therapy (P>۰.۰۵). The mean postoperative hemoglobin level in the harmonic group (۱۱.۸۳ ± ۱.۲۶) was significantly higher than in the monopolar group (۹.۰۴ ± ۱.۱۳) (P<۰.۰۰۱). The average duration of vaginal cuff separation was significantly shorter in the monopolar group (۲۲.۲۴ ± ۴.۵۹) compared to the harmonic group (۲۸.۷۰ ± ۵.۹۳) (P<۰.۰۰۱). Postoperative complications, particularly vaginal lacerations, were less frequent in the harmonic group (۴۵.۷%) than in the monopolar group (۶۰%) (P=۰.۰۱۵). The incidence of incidental findings, especially endometriosis, was lower in the harmonic group (۱۲.۴%) compared to the monopolar group (۲۳.۸%) (P=۰.۰۳۱). No cases of vaginal cuff dehiscence were observed in either group. Conclusion: This study demonstrated that vaginal cuff separation using harmonic scalpel in laparoscopic hysterectomy is associated with better outcomes compared to monopolar hook.

کلیدواژه ها:

Cuff ، Hysterectomy ، Hook ، Scalpel ، Postoperative complications