Lift-laparoscopic total hysterectomy as a routine procedure

Area of Science:

• Minimally Invasive Gynecologic Surgery
• Surgical Technology Innovation

Background:

• Traditional laparoscopic hysterectomy often relies on carbon dioxide (CO2) insufflation.
• CO2 insufflation can lead to complications and increased costs.
• Alternative methods are sought to improve patient outcomes and surgical efficiency.

Purpose of the Study:

• To evaluate the efficacy and safety of gasless Lift-laparoscopic total hysterectomy.
• To compare outcomes of this technique with other laparoscopic hysterectomy methods.
• To assess the cost-effectiveness and learning curve of the gasless approach.

Main Methods:

• A novel lift system was used to elevate the abdominal wall without CO2 insufflation.
• Bipolar diathermy scissors were employed for dissection of uterine vessels and ligaments.
• The uterus was removed transvaginally in 403 cases.
• Key variables including operative time, complications, blood loss, pain, hospital stay, and recovery were analyzed.

Main Results:

• Gasless Lift-laparoscopic hysterectomy demonstrated superior results across all examined variables compared to laparoscopic-assisted vaginal hysterectomy, supracervical hysterectomy, and total laparoscopic hysterectomy.
• The procedure exhibited lower costs and an effective learning curve.
• Reduced blood loss, shorter hospital stays, and faster convalescence were noted.

Conclusions:

• Gasless Lift-laparoscopic total hysterectomy presents a safe and effective alternative to conventional laparoscopic hysterectomy.
• Routine adoption of this technique could potentially decrease the incidence of complications associated with traditional surgical methods.
• The method offers significant advantages in terms of cost and surgical training.