Comparative Analysis of Vaginal Cuff Dissection Outcomes in Laparoscopic Hysterectomy: Monopolar Hook vs. Harmonic Scalpel

Background and Aims: This study aimed to compare the outcomes of vaginal cuff separation using monopolar hook or harmonic scalpel in laparoscopic hysterectomy. Materials and Methods: A retrospective analysis was conducted on 210 women who underwent laparoscopic hysterectomy between 2022 and 2024. A total of 105 cases for each surgical method were randomly selected from patient records. Demographic and clinical data were extracted from medical records and analyzed using IBM SPSS version 26. P-value < 0.05 was deemed as statistically significant. Results: The mean age in the harmonic and monopolar groups was 24.76 (±5.41) and 25.75 (±4.64) years, respectively. There were no statistically significant differences between the groups in terms of age, BMI, hospitalization, history of previous abdominal surgery, preoperative hemoglobin levels, and hormone therapy (P>0.05). The mean postoperative hemoglobin level in the harmonic group (11.83 ± 1.26) was significantly higher than in the monopolar group (9.04 ± 1.13) (P<0.001). The average duration of vaginal cuff separation was significantly shorter in the monopolar group (22.24 ± 4.59) compared to the harmonic group (28.70 ± 5.93) (P<0.001). Postoperative complications, particularly vaginal lacerations, were less frequent in the harmonic group (45.7%) than in the monopolar group (60%) (P=0.015). The incidence of incidental findings, especially endometriosis, was lower in the harmonic group (12.4%) compared to the monopolar group (23.8%) (P=0.031). No cases of vaginal cuff dehiscence were observed in either group. Conclusion: This study demonstrated that vaginal cuff separation using harmonic scalpel in laparoscopic hysterectomy is associated with better outcomes compared to monopolar hook.

Comparative Analysis of Vaginal Cuff Dissection Outcomes in Laparoscopic Hysterectomy: Monopolar Hook vs. Harmonic Scalpel Keywords:

Cuff , Hysterectomy , Hook , Scalpel , Postoperative complications