The Clinical Utility of a Pulsed Bipolar System and Its Electrosurgical Device During Total Laparoscopic Hysterectomy

Abstract

Abstract

Objective:

The aim of this research was to evaluate the efficacy and safety of the PlasmaKinetic™ (PK) PKS OMNI® (Gyrus ACMI, Maple Grove, MN) sealing device in laparoscopic hysterectomy.

Materials and Methods:

For this retrospective observational study, 60 patients who underwent multiport total laparoscopic hysterectomy between January 2014 and January 2015 in a tertiary-care university-based teaching hospital and an academically affiliated hospital were included in this study. The PKS OMNI is a bipolar electrosurgical device that takes energy from a PK generator workstation G400. This pulsed wave system has two different modes; cutting (High Cut 1,2,3) and coagulation (Vaporization 1,2,3).

Results:

Records of 60 patients were analyzed. The median age was 50 (range: ages 40–84), median body mass index was 26 kg/m² (range: 22–32 kg/m²), and median parity was 2 (range: 1–8). The median total operation time was 100 minutes (range: 70–240 minutes), estimated blood loss was 80 mL (range: 30–250 mL), and uterine weight was 207 g (range: 50–900 g). Degree of Surgical Difficulty and postoperative pain scores at rest were evaluated with a visual analogue scale system, from 0 to 10, and the medians of these scores were 5 (range: 3–7) and 4 (range: 2–6), respectively. The median recovery time of bowel movement was 16 hours (range: 8–26 hours), median spontaneous urination time was 7 hours (range: 4–29 hours), and median postoperative mobilization time was 8 hours (range: 6–10 hours). Conversion to laparotomy was needed in 1 patient due to severe pelvic adhesions. The median duration of hospital stay was 2 days (range: 2–4 days). Vaginal cuff dehiscence was detected in 1 (1.7%) patient who engaged in sexual intercourse on the 122nd day after surgery. Cuff cellulitis in 1 (1.7%) patient and unexplained fever in 1 (1.7%) patient were the other recorded complications. The median follow-up time was 12 months (range: 6–17 months).

Conclusions:

The PKS OMNI is a novel, underused energy modality that promotes quick recovery and acceptable operation time with minimal blood loss. (J GYNECOL SURG 33:253)