Reverse hysterectomy: another technique for performing a laparoscopic hysterectomy

Area of Science:

• Gynecologic Surgery
• Minimally Invasive Procedures
• Surgical Innovation

Background:

• Laparoscopic hysterectomy is a common procedure for benign gynecological conditions.
• Standard techniques may carry risks of visceral or ureteral injury.
• A modified retrograde approach (total reverse laparoscopic hysterectomy) was developed to enhance safety.

Purpose of the Study:

• To evaluate the outcomes of a modified total reverse laparoscopic hysterectomy.
• To assess the safety, efficiency, and patient satisfaction of this retrograde technique.

Main Methods:

• An observational study was conducted on 101 women undergoing total reverse laparoscopic hysterectomy for benign disease.
• The modified technique involves dissecting the anterior broad ligament leaf, preserving the posterior leaf.
• Data collected included surgical indications, patient characteristics, operative details, complications, and satisfaction.

Main Results:

• The modified technique involves creating a "safe triangle" for uterine vessel closure, aiding ureter identification.
• Average operating time was 112.1 minutes with mean blood loss of 79.5 mL.
• 90% of patients reported high satisfaction; no ureteral or bladder injuries occurred.

Conclusions:

• Total reverse laparoscopic hysterectomy is a safe and efficient alternative surgical technique.
• The retrograde approach minimizes the risk of major intraoperative complications.
• High patient satisfaction supports the clinical utility of this modified laparoscopic hysterectomy.