Laparoscopic-Assisted Vaginal Subtotal Hysterectomy

Chin‐Jung Wang, Wang CJ, Chin-Jung Wang, Yuen LT, Leung-To Yuen, Leung‐To Yuen, Lee CL, Chyi-Long Lee, Chyi‐Long Lee, Chih-Feng Yen, Chih‐Feng Yen, Soong YK, Yung-Kuei Soong, Yung‐Kuei Soong
Journal of laparoendoscopic & advanced surgical techniques. Part A · 2005 · vol. 15(1) , pp. 33–37 · doi:10.1089/lap.2005.15.33 · PMID:15772474 · W2015702352
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This study evaluated a combined laparoscopic and vaginal approach for subtotal hysterectomy in 21 women, finding it to be a safe alternative with acceptable operative times and minimal complications.

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Abstract

BACKGROUND: A novel approach in combined laparoscopic and vaginal procedures through the posterior cul-de-sac for subtotal hysterectomy is introduced. PATIENTS AND METHODS: Twenty-one women with menometrorrhagia, symptomatic adenomyosis, or uterine myomas were enrolled in this study. After laparoscopic dissection of bilateral round ligaments and adnexa, a guiding suture brought the uterine fundus down through the posterior cul-desac into the vagina via a posterior colpotomy. Subtotal hysterectomy and hemostasis of the cervical stump were then performed transvaginally by conventional techniques and equipment. RESULTS: Mean operative time, blood loss, and length of hospital stay were 111.2 +/- 28.8 minutes, 252.4 +/- 147.9 mL, and 3.2 +/- 0.9 days, respectively. No patients developed serious complications, but 1 patient had a postoperative stump infection and was treated with 2 combined antibiotics, uneventfully. CONCLUSION: A combined laparoscopic and vaginal approach in performing subtotal hysterectomy through the posterior cul-de-sac is an alternative to a purely laparoscopic approach.

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Condition tags

adenomyosis

MeSH descriptors

Hysterectomy, Vaginal Laparoscopy Anti-Bacterial Agents Blood Loss, Surgical Female Hemostasis, Endoscopic Hemostasis, Endoscopic Humans Hysterectomy, Vaginal Laparoscopy Length of Stay Menorrhagia Menorrhagia Metrorrhagia Metrorrhagia Middle Aged Surgical Wound Infection Surgical Wound Infection Time Factors Treatment Outcome

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References (15)

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