Nerve-sparing radical hysterectomy using modern bipolar electrosurgical instruments based on the forcetriad energy platform

Abstract

Objective : To describe and evaluate a novel technique of nerve-sparing radical abdominal hysterectomy with pelvic lymphadenectomy (NSRH/PLND) using the bipolar Ligasure Atlas sealer/divider and Bissenger bipolar shears. Methods: Retrospective study of 4 consecutive patients who underwent NSRH/PLND for stage IB1-IIB cervical carcinoma was conducted. Resection of the cardinal and uterosacral ligaments was performed with the Ligasure Atlas. Pelvic autonomic nerve dissection and lymphadenectomy were completed with the bipolar shears. Outcomes were collectively analyzed. Results: Mean operative time was 251 minutes (range, 230-265). Blood loss averaged 625 mL (range, 400-900). Average LOS was 5 days (range, 4-5). Average duration until normal postvoid residual volume was 17 days (range, 10-24). No perioperative complications were encountered. Conclusion: Bipolar surgical instrumentation offers many advantages. The Ligasure Atlas provides effi cient sealing and division of vascular pedicles, while the bipolar shears allow precise and fi ne dissection. Our results demonstrate the "bipolar sealer and shears technique" a preferable method of NSRH/PLND.