Laparoscopic Hysterectomy

Between April 1993 and November 1995 I performed 50 laparoscopic hysterectomies. The indications for surgery were chronic menometrorrhagia in 40 women, enlargement of the uterus in 8, and pelvic pain in 2. Bipolar coagulation was used in the first 20 cases exclusively and a combination of Endo GIA 30 and bipolar in the other 30. The operating time using only bipolar coagulation ranged from 90 to 120 minutes and with the Endo GIA 30 from 60 to 150 minutes. The mean hospital stay was 36 hours. Only four procedures were converted to laparotomy, three for uncontrolled bleeding and one for bladder injury. The two complications were a vesicovaginal fistula and a vaginal infection. I believe that laparoscopic hysterectomy can be performed when the surgeon has appropriate training in vaginal and general surgery.