[Laparoscopy-assisted vaginal hysterectomy with the Endo GIA 30]

The improvements in laparoscopic techniques have led to the development of laparoscopic assisted hysterectomy. We report on our experience since 1991 with this method on 30 patients using a Multifire Endo GIA 30. After cutting the upper ligaments and the uterine vessels, the uterus was removed through the vagina. To avoid urological complications, the distance between the ureter and the uterus was determined preoperatively by a combined sonographical-radiological procedure. To be absolutely safe from ureter lesions, it is recommended to use an illuminated ureter catheter. Laparoscopic hysterectomy should be used in selected cases only. In a critical indication situation with this technique, it is possible to avoid abdominal hysterectomy without loss of safety because of the excellent intraabdominal view, similar to laparotomy. There were no major complications with this procedure, except one ureter lesion, which was recognised intraoperatively. All patients remained in the hospital for only four days after the operation.