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[Laparoscopic hysterectomy. Initial experience]

B Torres del Toro, M Peimbert, J M Torres

    Ginecologia Y Obstetricia De Mexico
    |January 1, 1994
    PubMed
    Summary
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    Laparoscopic Assisted Vaginal Hysterectomy offers advantages for specific gynecological cases, despite a longer operative time and higher cost. This minimally invasive technique requires specialized training for gynecological surgeons.

    Area of Science:

    • Gynecological Surgery
    • Minimally Invasive Procedures

    Context:

    • Presents results from the initial twelve cases of Laparoscopic Assisted Vaginal Hysterectomy (LAVH).
    • Addresses indications including myomatosis, adenomyosis, and endometriosis.

    Purpose:

    • To detail the surgical technique combining bipolar Kleppinger forceps and reusable scissors.
    • To evaluate the outcomes, complications, and benefits of LAVH.

    Summary:

    • Average operative time was 4 hours 31 minutes, with no significant bleeding.
    • Two intraoperative accidents occurred: subcutaneous emphysema and epigastric artery branch damage.
    • Postoperative complications included hyponatremia and periumbilical hematoma; patients discharged within 1-3 days.
    • Average hospital fee was 35% higher than abdominal hysterectomy.

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    Impact:

    • LAVH is advantageous for hysterectomies without prolapse, with adnexectomy, prior pelvic surgery, endometriosis, or adhesions.
    • Recommends LAVH inclusion in gynecological surgeons' armamentarium after appropriate training.