Effective thermal destruction of residual tubal epithelium using an advanced sealing device in opportunistic salpingectomy: A randomized trial.

Choi, Hyun-Jin; Kim, Hyun-Soo; Kim, Tae-Joong; Song, Sang Yong; Paik, E Sun; Jin Heo, Eun; Park, Jin-Young; Lee, Yoo-Young; Choi, Chel Hun; Lee, Jeong-Won; Kim, Byoung-Gie; Bae, Duk-Soo

Objective To examine the effectiveness of proximal tube destruction at the uterine cornu by additional application of a sealing device. Methods A single-center randomized trial was conducted on 40 patients receiving a laparo-endoscopic single-site hysterectomy with opportunistic salpingectomy. We randomized patients into two groups at the time of admission to determine the laterality of additional thermal cauterization. Additional thermal cauterization for 10 seconds was applied on the right cornu in one group and on the left cornu in the other group. Three pieces of cornual tissue from each cornu were biopsied. One gynecological pathologist examined the cornual tissue to determine the residual tubal epithelium (TE) and thermal destruction of the specimens. Results Of the 40 patients enrolled in this study between September 2012 and July 2014, samples of 26 patients were subjected to tissue analysis. Residual TE was found in the cornu in 73.1% (19/26) and 65.4 % (17/26) of tissues from the side of no additional cauterization (NO) and the side of additional cauterization (AD), respectively (p < 0.001). Residual TE was detected in 5.3% (1/19) and 94.1% (16/17) of the specimens from the NO and AD groups, respectively. Conclusion We observed that a high incidence of residual TE and efficacious cauterization-induced thermal destruction was achieved following 10 seconds of additional cauterization. These results suggest that additional cauterization of the uterine cornu using the sealing device effectively destroys residual TE after salpingectomy.