Laparoscopic hysterectomy. A review of 72 cases

Seventy-two women underwent laparoscopic hysterectomy, some concomitant with other laparoscopic procedures. The surgery was performed with a combination of Kleppinger bipolar forceps for hemostasis, a scissors and/or CO2 laser for tissue division, CO2 laser for vaporization and excision of endometrial implants, and CO2 laser and scissors for lysis and excision of adhesions. There were no intraoperative complications. One patient, however, was readmitted to the hospital on the fifth postoperative day because of a fever but was discharged 48 hours later. The first 10 patients were discharged on the second postoperative day. The remaining 62 were to be discharged within 24 hours of admission; 59 of them were discharged then. The last three had to be admitted to the hospital; all were discharged on the second postoperative day. One week after surgery the patients were permitted to drive and resume normal, nonstrenuous physical activity. All the surgery was videotaped and later viewed by the patients. The laparoscopic approach to hysterectomy provided all the advantages of the abdominal approach with decreased morbidity, blood loss, postoperative discomfort, pain, length of hospitalization and recovery.