Randomized study comparing the use of Thunderbeat technology vs. standard electrosurgery during laparoscopic radical hysterectomy and pelvic lymphadenectomy for gynecological cancer.

To compare the use of Thunderbeat (TB) with standard electrosurgery (SES), during laparoscopic radical hysterectomy and pelvic lymphadenectomy for gynecological tumors, with respect to operative time DESIGN: Evidence obtained from a properly designed, randomized, controlled trial.classification: Canadian Task Force classification I SETTING: Gynecologic Oncology Unit of the Catholic University of the Sacred Heart in Rome PATIENTS: Fifty patients with early stage cervical cancer (FIGO stages IA2-IB1-IIA<2cm), locally advanced cervical cancer (FIGO stages IB2-IIA>2cm-IIB) submitted to neo-adjuvant treatment (chemotherapy or radio-chemotherapy) showing a complete/partial clinical response and early stage endometrioid endometrial (FIGO stages IB-II) were randomly assigned to undergo TB (arm A) and SES (arm B) INTERVENTION: Laparoscopic radical hysterectomies with bilateral pelvic lymphadenectomy, with an easily reproducible technique were performed.Fifty patients were available for the analysis, with 25 women randomly assigned to TB (arm A) and 25 to SES (arm B). The median operative time was 85 min vs. 115 min for TB and SES, respectively (p=0.001). At multivariate analysis, endometrial cancer (p=0.0001) and TB (p=0.001) were independently associated with less operating time. No differences in terms of peri-operative outcomes and post-operative complications were observed in both arms. Patients undergoing TB reported less post-operative pain, both at rest and after Valsalva' maneuver (p=0.005 and p=0.008, respectively), with less additional analgesics beside standard therapy than in arm B (p=0.02) CONCLUSION: TB is associated with shorter operative time and less post-operative pain than standard technique (SES) in patients with uterine cancer.