Histerectomía vaginal con termofusión, técnica innovadora: experiencia de 1000 casos

Objective: To present the advantages and benefits of applying the termofusion technique in hysterectomies. Material and methods: The clinical files of patients who underwent transvaginal hysterectomy with thermofusion were reviewed, from September 2004 to April 2008 (N = 1000). The Biclamp® equipment (VIO 300 ERBE), which allows the use of no sutures, was used in order to perfom vaginal hysterectomy. Filling out the registration document with the following data: anesthesia, preoperatory diagnosis, surgical time, postoperatory recovery, hospital stay, complications and incapacity. Analyzing the data by measures of central tendency, frequencies and percentages. Results: We studied 1000 patients, ages from 26 to 69, 38,5% of them with previous surgeries. Preoperatory diagnosis: Uterine miomatosis, 760 (76%); abnormal uterine hemorrhage, 89 (8,9%); uterine prolapse 65, (6,5%); hyperplasia of endometrium, 52 (5,2%); cervical cancer, 1 (0,1%); adenomyosis, 20 (2,0%); HPV dysplasia, 13 (1,3%). Epidural anesthesia 98%. Average surgical time 28 minutes. Average operating bleeding 163 ml. Weight of the uterus from 45 to 1500 g. Hospital stay from 1 to 2 days. Complications: Abscess of fundus, 9 patients (0,9%); Hemorrhage, 7 (0,7%); vesical injury, 8 (0,8%); vesicovaginal fistula, 2 (0,2 %); injury of the rectum, 1 (0,1%); thrombophlebitis, 1 (0,1%); sepsis, 1 (0,1%); conversion of vaginal hysterectomy to abdominal hysterectomy, 2 patients (0,2%). Conclusions: This technique decreases surgical time, operating bleeding, morbidity, hospital stay, time of incapacity and hospital expenses. Patient’s recovery is faster, improving the quality of life, thus becoming an innovating technique of minimum invasion without scars.