No increased morbidity was noted in comparison to LAVH, vaginal hysterectomy, or total abdominal hysterectomy performed within the same time period at the same institution. Two patients status post TLH were treated with oral antibiotics for mild vaginal cuff cellulitis with rapid resolution. Average hospital stay was 1.8 days for TLH, 1.9 days for LAVH, 2.3 days for vaginal hysterectomy, and 2.8 days for total abdominal hysterectomy. It is safer than standard electro surgery. By decreasing the amount of necrosing tissue, the risk of a fistula formation should be theoretically reduced and there should be less post-operative pain.
Harmonic scalpel is cost-effective relative to using staple devices.
This was facilitated by decreasing the need for instrument changes and using the bottom of the active harmonic scalpel blade as a cutting device to facilitate colpotomy. Initially we had concerns regarding transection of the uterine artery with the harmonic scalpel. We knew from related experience that it could be used to effectively coagulate vessels within the infundibulo pelvic ligament as well as gastric arteries. This gave us the opportunity to reassess the uterine pedicles laparoscopically after the procedure was essentially completed. There was no delayed bleeding noted at the uterine pedicles.