Laparoscopic hysterectomy

Michel Canis, G. Mage, Charles Chapron, Arnaud Wattiez, Jean Luc Pouly, M Bruhat
In: Surgical Endoscopy · 1993 · vol. 7(1) , pp. 42–45 · doi:10.1007/bf00591236 · PMID:8424233 · W2325029974
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⚙ AI-generated summary by gemini-2.5-flash-lite+body, 2026-06-12 ⓘ

Laparoscopic hysterectomy was completed in 72.7% of 33 selected patients, with nine requiring conversion to laparotomy, indicating safety in select cases but a need for further technological advancement.

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The paper describes a series of 33 selected patients who underwent laparoscopic hysterectomy in Clermont-Ferrand University Hospital, using blunt dissection with scissors and bipolar coagulation for hemostasis, with success defined as laparoscopic treatment of all uterine vessels. Of 24 cases completed laparoscopically (72.7%), the authors report no postoperative bleeding and 22 uneventful recoveries, while 9 procedures (27.3%) were converted to laparotomy, mainly for difficult or unsatisfactory hemostasis. The authors conclude the procedure can be performed safely in selected cases by experienced laparoscopists, while noting that further technological progress is needed and that comparative value versus other approaches must be demonstrated. Laparoscopic hysterectomy is one step in broader endoscopic gynecologic procedures and is relevant to endometriosis and/or adenomyosis via its inclusion in endometriosis surgical literature (e.g., the authors cite laparoscopic treatment of endometriosis elsewhere in the reference context), though this specific report is centrally about laparoscopic hysterectomy rather than endometriosis or adenomyosis.

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Abstract

Thirty-three patients were selected for laparoscopic hysterectomy and operated on in the Department of Obstetrics, Gynecology and Reproductive Medicine of Clermont-Ferrand University Hospital. Surgical techniques included blunt dissection with scissors and bipolar coagulation to achieve hemostasis. A case was considered successful when all the uterine vessels were treated by laparoscopy. Twenty-four cases were completed laparoscopically (72.7%). None of these patients had postoperative bleeding; 22 had an uneventful postoperative recovery. Nine procedures were converted to laparotomy (27.3%), five because of a difficult or unsatisfactory hemostasis. We conclude that in selected cases, a total hysterectomy can be performed safely by experienced laparoscopists. Further technological progress is necessary to make this procedure more acceptable. Its value as compared to the others will have to be demonstrated.
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Summary Thirty-three patients were selected for laparoscopic hysterectomy and operated on in the Department of Obstetrics, Gynecology and Reproductive Medicine of Clermont-Ferrand University Hospital. Surgical techniques included blunt dissection with scissors and bipolar coagulation to achieve hemostasis. A case was considered successful when all the uterine vessels were treated by laparoscopy. Twenty-four cases were completed laparoscopically (72.7%). None of these patients had postoperative bleeding; 22 had an uneventful postoperative recovery. Nine procedures were converted to laparotomy (27.3%), five because of a difficult or unsatisfactory hemostasis. We conclude that in selected cases, a total hysterectomy can be performed safely by experienced laparoscopists. Further technological progress is necessary to make this procedure more acceptable. Its value as compared to the others will have to be demonstrated. Similar content being viewed by others References Backmann GA (1990) Hysterectomy: a critical review. J Reprod Med 35: 839–862 Benedet JL, Turko M, Boyes DA, Nickerson KG, Bienkwska BT (1980) Radical hysterectomy in the treatment of cervical cancer. Am J Obstet Gynecol 137: 254–262 Canis M, Mage G, Manhes H, Pouly JL, Wattiez A, Bruhat MA (1989) Laparoscopic treatment of endometriosis. Acta Obstet Gynecol Scand Suppl 150: 15–20 Canis M, Mage G, Wattiez A, Pouly JL, Manhes H, Bruhat MA (1990) La chirurgie endoscopique a t elle une place dans la chirurgie radicale du cancer du col uterin. J Gynecol Obstet Biol Reprod (letter) 19: 921 Derman SG, Rehnstrom J, Neuwirth RS (1991) The long term effectiveness of hysteroscopic treatment of menorrhagia and leiomyomas. Obstet Gynecol 77: 591–594 Dicker RC, Greenspan JR, Strauss LT, et al (1982) Complications of abdominal and vaginal hysterectomy among women of reproductive age in the United States. The collaborative review of sterilization. Am J Obstet Gynecol 144: 841–848 Dicker RC, Scally MJ, Greenspan JR, et al (1982) Hysterectomy among women of reproductive age. Trends in the United States 1970–1978. JAMA 248: 323–327 Goldrath MH, Fuller TA, Segal S (1981) Laser vaporization of the endometrium for the treatment of menorrhagia. Am J Obstet Gynecol 140: 14–19 Jasczak SE, Evans TN (1982) Intrafascial abdominal and vaginal hysterectomy: a reappraisal. Obstet Gynecol 59: 435–444 Kovacs SR, Cruikshanks H, Rettoh F (1990) Laparoscopy assisted vaginal hysterectomy. J Gynecol Surg 6: 185–193 Larson DM, Malone JM, Copeland LJ, Gershenson DM, Kline RC, Stringer CA (1987) Ureteral assessment after radical hysterectomy. Obstet Gynecol 69: 612–616 Mage G, Canis M, Manhes H, Pouly JL, Wattiez A, Bruhat MA (1990) Laparoscopic management of adnexal cysts. J Gynecol Surg 6: 71–79 Mage G, Canis M, Wattiez A, Pouly MA, Bruhat MA (1990) Hysterectomie et Coelioscopie. J Gynecol Obstet Biol Reprod 19: 569–573 Nezhat C, Crowgey S, Nexhat F (1990) Videolaseroscopy for the treatment of endometriosis associated with infertility. Fertil Steril 51: 237–240 Nezhat C, Nezhat F, Silfen SL (1990) Laparoscopic hysterectomy and bilateral salpingo-oophorectomy using multifire GIA surgical stapler. J Gynecol Surg 6: 287–288 Parker WH, Berk JS (1990) Management of selected cystic adnexal masses in postmenopausal women by operative laparoscopy. Am J Obstet Gynecol 163: 1574–1577 Pouly JL, Manhes H, Mage G, Canis M, Bruhat MA (1986) Conservative laparoscopic treatment of 321 ectopic pregnancies. Fertil Steril 46: 1093–1097 Querleu D, Leblanc E, Castelain B (1991) Laparoscopic lymphadenectomy in the staging of early carcinoma of the cervix. Am J Obstet Gynecol 164: 579–581 Reich H (1987) Laparoscopic oophorectomy and salpingo-oophorectomy in the treatment of benign tubo-ovarian disease. Int J Fertil 32: 233–236 Reich H, De Caprio J, Mc Glynn F (1989) Laparoscopic hysterectomy. J Gynecol Surg 5: 213–216 Reich H (1991) Pelvic sidewall dissection. Clin Obstet Gynecol 34: 412–422 Reiner IJ (1988) Early discharge after vaginal hysterectomy. Obstet Gynecol 71: 416–418 Webb MJ, Symmonds RE (1979) Wertheim hysterectomy: a reappraisal. Obstet Gynecol 54: 140–145 Wingo PA, Huezo CM, Rubin GL, Ory HW, Peterson HB (1985) The mortality risk associated with hysterectomy. Am J Obstet Gynecol 152: 803–808 Author information Authors and Affiliations Rights and permissions About this article Cite this article Canis, M., Mage, G., Chapron, C. et al. Laparoscopic hysterectomy. Surg Endosc 7, 42–45 (1993). https://doi.org/10.1007/BF00591236 Issue date: DOI: https://doi.org/10.1007/BF00591236

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