Laparoscopic hysterectomy with retroperitoneal uterine artery sealing using LigaSure™: Gazi hospital experience

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This study evaluated laparoscopic hysterectomy using retroperitoneal uterine artery sealing with LigaSure in 50 women, finding it effective and safe with minimal bleeding and short hospital stays.

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This prospective study evaluated laparoscopic hysterectomy performed using retroperitoneal uterine artery sealing with LigaSure™ in 50 women with various indications, measuring mean operation time, intraoperative bleeding proxies (hemoglobin drop), uterine specimen weight, postoperative complications, and conversion to laparotomy. The mean operation time was 85 minutes and mean hemoglobin decreased by 0.4 g/dl by postoperative day 1; one major complication (cystotomy) occurred in a patient with severe adhesions after two prior cesarean sections repaired laparoscopically. Only one patient required conversion to an open abdominal approach due to severe bowel adhesions associated with rectovaginal endometriosis, and all patients were discharged on postoperative day 1 with no minor complications reported. This paper is centrally about endometriosis — it reports a key surgical failure/conversion case attributable to rectovaginal endometriosis during laparoscopic hysterectomy.

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Abstract

ObjectiveThe aim of this study was to evaluate the efficacy and safety of laparoscopic hysterectomy by retroperitoneal sealing of the uterine arteries with LigaSure.MethodsLaparoscopic hysterectomy by retroperitoneal uterine artery sealing with LigaSure was performed by four-puncture laparoscopy in 50 women with various indications for hysterectomy. The mean operation time, amount of intraoperative bleeding, drop in hemoglobin concentration, weight of removed uterus, major and minor per-post operative complications, and the rate of conversion to classical abdominal approach were analyzed prospectively.ResultsThe mean operation time was 85 min (range 60-125 min). The mean weight of removed uterus was 180 g (range 60-650 g). There was one major complication; one patient had cystotomy due to difficulty in dissecting severe adhesions because of two previous cesarean sections that were repaired laparoscopically. Only one patient converted to laparotomy because of severe bowel adhesions due to rectovaginal endometriosis. All patients were discharged on the first postoperative day. No minor complications occurred. Hemoglobin decreased a mean of 0.4 g/dl (range 0.2-1.4 g/dl) by postoperative day 1.ConclusionLaparoscopic hysterectomy by retroperitoneal uterine artery sealing with LigaSure is an effective, safe, and fast procedure with less intra operative bleeding, short operation time and hospital stay.
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Abstract

Objective The aim of this study was to evaluate the efficacy and safety of laparoscopic hysterectomy by retroperitoneal sealing of the uterine arteries with LigaSure™.

Methods

Laparoscopic hysterectomy by retroperitoneal uterine artery sealing with LigaSure was performed by four-puncture laparoscopy in 50 women with various indications for hysterectomy. The mean operation time, amount of intraoperative bleeding, drop in hemoglobin concentration, weight of removed uterus, major and minor per-post operative complications, and the rate of conversion to classical abdominal approach were analyzed prospectively.

Results

The mean operation time was 85 min (range 60–125 min). The mean weight of removed uterus was 180 g (range 60–650 g). There was one major complication; one patient had cystotomy due to difficulty in dissecting severe adhesions because of two previous cesarean sections that were repaired laparoscopically. Only one patient converted to laparotomy because of severe bowel adhesions due to rectovaginal endometriosis. All patients were discharged on the first postoperative day. No minor complications occured. Hemoglobin decreased a mean of 0.4 g/dl (range 0.2–1.4 g/dl) by postoperative day 1.

Conclusion

Laparoscopic hysterectomy by retroperitoneal uterine artery sealing with LigaSure is an effective, safe, and fast procedure with less intra operative bleeding, short operation time and hospital stay. Similar content being viewed by others

References

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MeSH descriptors

Hysterectomy Laparoscopy Uterus Adult Aged Arteries Arteries Blood Loss, Surgical Female Humans Hysterectomy Intraoperative Complications Laparoscopy Ligation Ligation Middle Aged Retroperitoneal Space Time Factors Treatment Outcome Uterus

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