Comparative Analysis of Electrosurgical Energy and Hemostatic Sealant for Hemostasis in Laparoscopic Ovarian Cystectomy: A Randomized Controlled Phase III Study

Abstract

Study Objective

To evaluate the efficacy of hemostatic sealant versus electrosurgical energy in achieving hemostasis and preserving postoperative ovarian reserve during laparoscopic ovarian cystectomy.

Design

Randomized controlled trial.

Setting

Single-center study.

Patients

A total of 121 patients undergoing laparoscopic ovarian cystectomy.

Interventions

Patients were randomized to receive either hemostatic sealant or electrosurgical energy for hemostasis during surgery.

Measurements and Main Results

The primary outcome measured was the time required to achieve hemostasis. Secondary outcomes included operating time, estimated blood loss, and assessment of postoperative ovarian reserve through hormone levels (anti-Müllerian hormone [AMH], follicle-stimulating hormone [FSH], E2, inhibin) at three follow-up intervals. The results showed comparable hemostasis times between the two groups. Postoperative hormone levels indicated no significant differences in the impact on ovarian reserve between the groups, except in cases of bilateral ovarian cystectomy, where the hemostatic sealant group exhibited a lesser decline in AMH levels.

Conclusion

Both hemostatic sealant and electrosurgical energy showed equivalent effectiveness in achieving hemostasis during laparoscopic ovarian cystectomy, with comparable results in hemostasis time, blood loss, postoperative complications, and ovarian reserve preservation. However, in cases of bilateral ovarian cystectomy, the hemostatic sealant group exhibited a lesser decline in AMH levels, suggesting a potential advantage in preserving ovarian reserve in these specific cases.