Iraqi Postgraduate Medical Journal

Abstract

BACKGROUND:
Hysterectomy, the second most common surgical procedure performed in female patients, is
associated with various complications like other major surgical procedure.To reduce such
complications and shorten both ,the operating time and the intraoperative blood loss, sutureless
hysterectomy was recently practiced using novel vessel sealing devices as marClamp® IQ and
LigaSure.
OBJECTIVE:
To compare the outcomes of marClamp® total abdominal hysterectomy (TAH) versus total
abdominal hysterectomies performed by LigaSure and suture ligature techniques of other studies.
PATIENTS AND METHODS:
A total of 47 female patients presenting with various benign and malignant uterine and malignant
ovarian diseases were suturelessly hysterectomised using marClamp® .
Main outcome measures: The primary outcome measures were: the operating time and blood loss
while the secondary outcome measures were: intraoperative and post-operative complications,
hospital stay and histopathologic results of the removed specimens.
RESULTS:
Operating time of marClamp®: TAH only, TAH +bilateral salpingo-oopherectomy (BSO),
TAH+BSO+ infracolic omentectomy and total study group were: mean±SD = 60.91±8.31minute
(m) ,75.93±14.61m, 83.89±13.18 m and 73.94±15.11m respectively (P-value =0.001, it was
statistically significant ). The intraoperative blood losses of marClamp®: TAH only, TAH + BSO,
TAH+BSO +infracolic omentectomy and total study group were: mean±SD = 64.09±8.61 mililiter
(ml) , 85.74±17.30 ml ,103.33±20.62 ml and 84.04±20.71 ml respectively (P-value =0.000, it was
statistically significant ). Hospital stay of this study was mean±SD =2.08±0.59 day. This study had
no intraoperative complications .Its postoperative complication rate was 10.63 %. Premenopausal
simple endometerial hyperplasia with / without atypea was the most common histopathologic variety
(51%) .This study had no mortality during the follow-up period.
CONCLUSION:
The use of marClamp® IQ device can reduce operating time, intraoperative blood loss,
intraoperative and postoperative complication rates and the hospital stay. Thus it is cost-effective.
It allows quick and secured hemostasis compared with the conventional suture ligature technique.