Clinical and Experimental Obstetrics & Gynecology (CEOG) is published by IMR Press from Volume 47 Issue 1 (2020). Previous articles were published by another publisher on a subscription basis, and they are hosted by IMR Press on imrpress.com as a courtesy and upon agreement with S.O.G.
Inflammatory response and tissue trauma in laparoscopic hysterectomy: comparison of electrosurgery and harmonic scalpel
Objective: Our aim was to quantify and compare clinical outcome and surgical inflammatory response and tissue trauma after laparoscopic hysterectomy for a benign disorder which was perfomed by electrosurgery or harmonic scalpel. Methods: Sixty patients scheduled for laparoscopic hysterectomy were selected according to patient preference to undergo either electrosurgery or an ultrasonic operative technique. Blood samples for assay of markers of tissue trauma (C-reactive protein, interleukin-6, creatine kinase, white blood cell count) were taken preoperatively, on the first and third postoperative day. Three patients with intraoperative complications or incomplete records were excluded from tissue analysis. Results: No differences were present in the demographic characteristics and clinical outcomes (blood loss, uterine weight, operating time and hospital stay) in 57 uncomplicated laparoscopic hysterectomies. Both electrosurgery (n = 36) and use of the harmonic scalpel (n = 21) resulted in statistically significant changes in the inflammatory and systemic immune response in comparison with preoperative values. No significant differences were observed in the studied inflammatory and tissue markers (C-reactive protein, interleukin-6, creatine kinase and white blood cells) between the compared groups. Conclusion: The harmonic scalpel and electrosurgery in laparoscopic hystsrectomy were equally traumatic in terms of surgical inflammatory response and tissue trauma.