الفهرس 
The history of vaginal hysterectomyOnly 14 pages are availabe for public view
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Abstract
Vaginal hysterectomy meant a shorter stay in hospital compared with abdominal hysterectomy a speedier return to normal activities for the patient and fewer unspecified infections or febrile episodes. There was no evidence of benefits for laparoscopic hysterectomy compared with vaginal hysterectomy and the operating time was increased for laparoscopic hysterectomy. (Johnson et al., 2005).
Electrosurgical bipolar vessel sealing (EBVS) systems have been developed to seal large tissue bundles and blood vessels, up to 7 mm. diameter for some models.. (Peirce et al., 2007).
• Seals vessels from 1 to 7 mm in diameter,
• Precise amount of bipolar energy and mechanical pressure to fuse collagen and elastin within the vessel walls.
• withstand at minimum of three times normal systolic pressure, the result is permanent
• Single application.
• Avoids needlestick injuries
• Visible, possibly translucent seal. The seal is created using the body’s own collagen to actually change the nature of the vessel walls and obliterate the lumen
The collagen and elastin within the tissue melt and reform to create the (SEAL ZONE)
(Figure showing seal zone)
So, vaginal hysterectomy by using LigaSure decrease operative time and operative blood loss.
LigaSure equipment can be cost-effective due to savings occurred from reduced length of stay. Investing in this new technology has the potential to make the transition from abdominal to vaginal hysterectomy easier and economically valiable. (Peirce et al., 2007).
There is reduction in postoperative pain when using LigaSure in vaginal hysterectomy.
The aim of the current study was to assess the safety and efficacy of using the electrosurgical bipolar vessel sealing system for securing the pedicles during vaginal hysterectomy in comparison with the conventional method of securing the pedicles by suture ligation.
50 patients for vaginal hysterectomy for benign pathology with inclusion criteria mentioned before, had vaginal hysterectomy either by LigaSure or traditional sutures as a haemostatic technique divided into two groups:
Group 1or (S): (25 patients) vaginal hysterectomy using traditional ligature . group.
Group 2 or (L) : ( 25 Patients ) vaginal hysterectomy using bipolar energy source (LigaSure).
Complete preoperative assessment was done including history, examination and pre-operative investigation.
Anesthesia and pre-operative assessment under anesthesia were done.
Procedure time was defined as time from initial mucosal injection to closure of the vaginal cuff with satisfactory haemostasis. Blood loss was estimated intraoperatively from the amount of blood in the suction bottle and the number of gauzes and towel used and to which degree they were socked, and postoperatively by measuring haemoglobin and haematocrit values. Discharge from hospital was also reported.
RESULTS:
Use of electrosurgical bipolar vessel sealing resulted in shorter procedure times: The mean procedure time in the electrosurgical bipolar vessel sealing arm was 61.7 19.1 minutes versus 93.2 14.03 minutes for the suture arm (P < 0.001); this shorting in the operative time resulted from shorting of the pedicle dissection time.
Mean estimated blood loss was also statistically less with electrosurgical bipolar vessel sealing: 345.9 (range 150-700 ml.) versus 581.6 (range 3000-1200 ml) for the suture arm (P <0.001).
Complication rate and length of stay did differ by haemostasis technique.
CONCLUSION:
Electrosurgical bipolar vessel sealing (EBVS) is an effective alternative to sutures in vaginal hysterectomy, resulting in significantly reduced operative time and blood loss.