Vessel Sealing Hysterectomy Guide: Selecting the Right Laparoscopic Device

Where vessel sealing is used in laparoscopic hysterectomy

A laparoscopic hysterectomy involves several pedicles: round ligaments, the infundibulopelvic or utero-ovarian ligaments, the broad ligament with its vascular bundles and the uterine arteries. A bipolar vessel sealer coagulates and then cuts these structures, reducing the need to swap between a coagulating instrument, clip applier and scissors.

The same technology is used when the fallopian tubes are removed, in laparoscopic hysterectomy with bilateral salpingectomy, and in other gynaecological procedures. The surgeon decides which technique suits each case. For departments that perform many hysterectomies, a reliable sealer also helps to keep operating time predictable, which makes theatre planning easier.

How a bipolar vessel sealer works

A bipolar sealer grips the vessel between two jaws, applies controlled pressure and bipolar current, and monitors tissue feedback. Collagen and elastin in the wall denature and fuse into a seal, and a blade or separate energy then divides the sealed zone. Generator algorithms stop delivery when the seal is complete.

Because the effect depends on jaw pressure, tissue type and generator software, manufacturers specify which instruments pair with which generators. Always use the combination approved in the instructions for use.

What to compare in a vessel sealing device

Evaluate the device against workflow requirements. Vessel size rating, jaw length, jaw shape for dissection, shaft length and diameter, ergonomics, tip visibility and thermal spread all influence surgical comfort.

Also consider whether it is reusable or single use, how it integrates with your generator and what happens at the end of life. Neutral selection questions are more useful than brand claims, since several manufacturers, including the well-known Ligasure family, offer devices in this class.

• Maximum sealed vessel diameter
• Jaw length for sealing and cutting
• Tip shape for dissection and entry between layers
• Shaft rotation and locking
• Generator compatibility and instrument recognition
• Cost per case and reprocessing

BOWA ERGOseal and the ARC 400 generator

The BOWA ERGOseal combines dissection, sealing and separation in one instrument, with vessels up to 7 mm sealed and cut. Its Maryland jaw gives a 22 mm sealing length and a 20 mm cutting length, and the distal tip is shaped for blunt dissection. Separate triggers control sealing and cutting, the shaft rotates 360 degrees and the locking function can be switched on or off. It is offered as ERGOseal 230, 370 and 440 Maryland.

Paired with the ARC 400 in ARCseal mode, ERGOseal is recognised automatically through the COMFORT system. The ARC 400 offers up to 400 W monopolar and 400 W bipolar power, a LIGATION function for bipolar vessel sealing and memory for 300 favourite settings.

Setting up a hysterectomy line

Combine the sealing device with the other items of a laparoscopic hysterectomy set: a uterine manipulator, a morcellator or specimen retrieval bag, and supracervical tools such as the MetraLOOP. See laparoscopic hysterectomy instruments and uterine manipulator types for the surrounding equipment.

Beckfinity specialists can configure a BOWA energy and instrument package for your theatre; please request a quote or consultation, and confirm current UAE registration requirements with the relevant authority.