A review of the technique and complications from 2,012 cases of laparoscopically assisted vaginal hysterectomy at a single institution.

Abstract

AIMS:

To present our experience of modified laparoscopically assisted vaginal hysterectomy (LAVH) and to evaluate the surgical outcomes and complications.

METHODS:

Women with benign gynaecologic tumours that underwent a modified LAVH at the Samsung Medical Centre were analysed retrospectively. The technique is primarily a vaginal hysterectomy with a minor component of the laparoscopic procedures (stage 2 laparoscopic hysterectomy (LH)) and had two modifications (vaginal anterior colpotomy and McCall culdoplasty) from the standard technique.

RESULTS:

A total of 2012 LAVH procedures were performed from January 2000 to May 2008. The mean duration of the operations and the uterine weight were 102±32 min and 305±168 g, respectively. In 196 (9.7%) cases, the uterine weight was more than 500 g. Conversion to laparotomy was needed in 97 cases. Major intraoperative complications occurred in 45 cases (2.2%): bladder injury, 26 (1.29%); bowel injury, nine (0.45%); haemorrhage of major vessels, nine (0.45%); and ureteral injury, one (0.05%). Major long-term complications occurred in three cases: one fistula and two trocar site herniations.

CONCLUSIONS:

Stage 2 LH combined with modified vaginal anterior colpotomy and modified McCall culdoplasty is safe and effective for benign gynaecologic tumours and the prevention of post-LAVH vaginal prolapse.

• Authors: Taejong Song, Tae-Joong Kim, Heeseok Kang, Yoo-Young Lee, Chel Hun Choi, Jeong-Won Lee, Byoung-Gie Kim, Duk-Soo Bae
• Journal: The Australian & New Zealand journal of obstetrics & gynaecology (Aust N Z J Obstet Gynaecol) Vol. 51 Issue 3 Pg. 239-43 (Jun 2011) ISSN: 1479-828X [Electronic] Australia
• PMID: 21631443 (Publication Type: Journal Article)
• Copyright: © 2011 The Authors. Australian and New Zealand Journal of Obstetrics and Gynaecology © 2011 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

Topics

• Adult
• Colon (injuries)
• Female
• Hemorrhage (etiology)
• Humans
• Hysterectomy, Vaginal (adverse effects, methods, statistics & numerical data)
• Intraoperative Complications (epidemiology)
• Laparoscopy (adverse effects, methods, statistics & numerical data)
• Laparotomy (adverse effects, statistics & numerical data)
• Middle Aged
• Postoperative Complications (epidemiology)
• Retrospective Studies
• Surgical Instruments (adverse effects)
• Urethra (injuries)
• Urinary Bladder (injuries)
• Uterine Prolapse (prevention & control)
• Vesicovaginal Fistula (etiology)