الفهرس 
Aim of the workOnly 14 pages are availabe for public view
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Abstract
Hysterectomy is one of the most commonly performed gynecological procedures. The commonest indications for hysterectomy are all benign conditions such as abnormal uterine blood loss, dysmenorrhea, chronic pelvic pain, leiomyoma, and adenomyosis. The main goal of removal of the uterus is to improve quality of life. Therefore, possible side-effects of hysterectomy, which negatively influence the quality of life, have to be carefully evaluated and if possible limited. (Lakeman et al., 2012).
During the past few years, a variety of energy-based techniques for vessel ligation have been developed. Electrosurgical bipolar vessel sealing (EBVS) has become established in both open and laparoscopic surgery. A variety of studies have indicated that the technique is capable of safely sealing vascular structures with diameters up to 7 mm by denaturing collagen and elastin within the vessel wall and in the surrounding connective tissue. Several advantages of the use of EBVS during vaginal hysterectomy such as less blood loss, reduced postoperative pain, and shorter admission stay were documented. Only few randomized trials have compared conventional suturing and EBVS in patients undergoing abdominal hysterectomy for benign conditions.
Conventional bipolar energy devices are safer but since they cannot cut tissue, another cutting instrument (i.e. scissors) must be used, an extra task interfering with ease of surgery, prolonging operative time and causing a crowded operation field. Advanced bipolar devices have overcome almost all of these disadvantages with their superior vessel sealing capabilities, especially in blood vessels up to 7 mm diameter.