ANALYTICAL REVIEW AND METHODOLOGICAL ASSESSMENT OF LIGASURE USE IN HYSTERECTOMY IN THE REPUBLIC OF UZBEKISTAN

Abstract

Relevance. Hysterectomy remains one of the most common procedures in gynecology and gynecologic oncology [1]. In Uzbekistan, not only surgical efficacy but also rational allocation of high-technology consumables, hemostatic safety, reduction of perioperative risks, and economic justification for the implementation of new instruments are of particular importance [5, 7]. Objective. To conduct an analytical review and methodological assessment of the bipolar vessel-sealing system LigaSure in hysterectomy, determine rational indications and limitations, and propose a framework for future clinical evaluation in gynecologic oncology practice in the Republic of Uzbekistan. Materials and Methods. An analytical review of clinical studies, systematic reviews, health technology reports, and guidelines addressing the use of advanced bipolar vessel-sealing systems in abdominal, laparoscopic, vaginal, and radical hysterectomy was performed [1, 3-5]. A methodological framework for future comparative research was developed without presenting artificially generated clinical outcomes. Results. LigaSure may reduce blood loss, accelerate individual operative stages, and improve the reproducibility of hemostasis, particularly in patients with obesity, a large uterus, extensive adhesions, re-operative procedures, and radical gynecologic oncology operations [3-6]. However, universal application is not always justified because of cost, risk of thermal injury, and the limited clinical significance of advantages in standard uncomplicated hysterectomies [3, 5]. Conclusion. For Uzbekistan, a selective model of LigaSure use appears methodologically and clinically justified [5, 7]. A retrospective-prospective study evaluating blood loss, operative duration, complications, transfusions, hospital days, and treatment costs is methodologically appropriate [3-5].