Radical hysterectomy with the endoscopic stapler.

OBJECTIVE

Morbidity associated with radical hysterectomy is significant. Utilizing the endoscopic stapler for transection of the cardinal ligaments and uterosacral ligaments is a possible method to decrease operative time and blood loss.

METHODS

Two groups of patients, one group with the stapler used (n = 21) and the other with the traditional method utilized (n = 18), were compared in regard to operative and postoperative morbidity, operative time, and surgical margins. The groups were similar in regard to medical condition, age, and weight.

RESULTS

Median (243 min versus 284 min) and mean (246 min versus 287 min) operative times were significantly less in the stapler group than in the control group (P < 0.002). Median blood loss was reduced by 20% in the stapler group (400 ml versus 500 ml, P < 0.03). There was no significant difference in febrile morbidity, surgical complications, or length of hospital stay.

CONCLUSION

Our data suggest significant reduction in blood loss and operative time with the use of the endoscopic stapler.