INTRODUCTION:: A novel surgical technique to reduce blood loss during cesarean hysterectomy (Chyst) for placenta accreta spectrum disorder (PAS) was previously described (LC-VSS: hysterotomy using linear cutter and dissection of the bladder using vessel sealing system before clamping uterine arteries). We hypothesized that LC-VSS reduces intra- and post-operative complications. METHODS:: After IRB approval, PAS cases from 2014 to 2019 were reviewed. Gravid hysterectomy, interval hysterectomy and focal resection were excluded. Data collected includes patient demographics, estimated blood loss (EBL), number of intra-operative blood products, massive transfusion, organ injuries and post-operative complications (intensive care unit (ICU) admission, re-laparotomy, hospital stay). Chyst without using LC-VSS was marked as control. Impact of LC-VSS was analyzed using univariate analysis. Predictors for transfusion of more than 4 packed red blood cells (PRBCs) were assessed using regression analysis including pathology (accreta-increta vs percreta), surgical technique and urgency. RESULTS:: Of 59 cases, LC-VSS was used in 39 cases (66%). EBL was significantly lower in LC-VSS cases compared to controls (1200 vs 3330 ml, P=.0001) as well as the number of PRBCs and fresh frozen plasma transfused (0 vs. 4, P<.0001, and 0 vs 2, P=.0007, respectively). The number of massive transfusions was lower in LC-VSS cases (1 vs. 7, P=.002). Need for re-laparotomy was lower in LC-VSS patients (0 vs. 20%, P=.01). Median hospital stay was similar between groups. LC-VSS was the only predictor of blood transfusion less than 4 units of PRBCs (P=.004). CONCLUSION:: Use of this novel surgical technique (LC-VSS) during Chyst for PAS improves intra- and post-operative outcomes.