The aim of this randomized trial was to compare the degree of surgical smoke obstructing vision and thermal damage caused by two different ESDs (ultrasonic versus monopolar ESD) in colpotomy during total laparoscopic hysterectomy.

According to previous studies performed in porcine and bovine tissues, ultrasonic energy based surgical devices (ESDs) created less surgical smoke, involved less visual obstruction, and produced less lateral thermal damage than monopolar ESDs. However, there was no study comparing ultrasonic ESD and monopolar ESD in laparoscopic colpotomy in terms of surgical smoke and lateral thermal damage. Therefore, the aim of this randomized trial was to compare the degree of surgical smoke obstructing vision and thermal damage caused by two different ESDs (ultrasonic versus monopolar ESD) in colpotomy during total laparoscopic hysterectomy.

Inclusion Criteria:

• women with gynecologic diseases, such as uterine myoma, adenomyosis, and ovarian tumor;
• women who were planning to undergo TLH;
• women between 19 and 75 years of age.

Exclusion Criteria:

• women with any suggestion of malignant cervical or vaginal pathologies
• women with uncontrolled medical comorbidities or psychiatric illness, which could affect follow-up and/or compliance
• women who refused to participate or give consent to the procedures.