Avoidance of complications of laparoscopic hysterectomy

The laparoscopic approach to hysterectomy offers the patient very considerable advantages over the open surgical approach. Claims that operations can 'always be done vaginally' are false. Such claims are based on inappropriate patient selection. Comparisons between vaginal hysterectomy and the laparoscopic approach betray illogical thinking: they are two different operations for very different patients. For safe practice, the surgeon must be properly trained and experienced before attempting advanced laparoscopic surgery, including hysterectomy, and patients must be carefully selected for their suitability to undergo such operations. There are a number of specific precautions and manoeuvres detailed here which may greatly enhance the safety of laparoscopic hysterectomy and reduce complications to an absolute minimum in the hands of the trained laparoscopic surgeon.