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Small intestine injury in laparoscopic-assisted vaginal hysterectomy
Chung-Chang Shen1, Ming-Ping Wu, Cheng-Hsien Lu
1Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Kaohsiung, Taiwan.
Study Objective:
To review laparoscopic-assisted vaginal hysterectomy (LAVH) cases for instances of small intestine injury.
Design:
Retrospective review (Canadian Task Force Classification II-2).
Setting:
Tertiary care university hospital.
Patients:
Two thousand six hundred eighty-two women.
Intervention:
LAVH.
Measurements And Main Results:
Indications for hysterectomy were myomata uteri, adenomyosis, intractable menorrhagia, endometriosis, severe pelvic adhesions, cervical intraepithelial neoplasia, endometrial polyps, and hyperplasia. Small bowel injuries occurred in five women (1.9/1000), one (20%) of which was recognized postoperatively. Thermal injuries occurred in two patients, trocar injuries in two, and a dissection wound in one. Two-layer closure was performed for three patients, and partial resection with reanastomosis for two. All patients were discharged without sequelae.
Conclusion:
Small bowel injury during LAVH is not common. It may have unusual characteristics and devastating consequences if not recognized and treated promptly.