Small bowel herniation after laparoscopically assisted vaginal hysterectomy

Area of Science:

• Minimally Invasive Gynecologic Surgery
• Surgical Complications
• Abdominal Wall Closure

Background:

• Laparoscopically assisted vaginal hysterectomy (LAVH) is increasingly common in the U.S.
• LAVH is generally associated with minimal complications.
• Small bowel obstruction is a potential complication following abdominal surgery.

Purpose of the Study:

• To evaluate the complication rate of LAVH.
• To specifically assess the incidence of small bowel obstruction after LAVH.
• To compare the risk of small bowel obstruction in LAVH versus standard abdominal hysterectomy.

Main Methods:

• Retrospective review of 90 patients undergoing LAVH.
• Analysis of complication rates, focusing on small bowel obstruction.
• Comparison of complication rates with historical data from abdominal hysterectomy.

Main Results:

• A 3% rate of small bowel obstruction was observed in the LAVH group.
• This complication rate is higher than that reported for standard abdominal hysterectomy.
• The study identified a potential link between port site closure and obstruction.

Conclusions:

• Small bowel obstruction is a significant complication of LAVH.
• Closure of lateral abdominal wall port sites under direct laparoscopic visualization is recommended.
• This preventative measure may reduce the incidence of bowel obstruction after LAVH.