One Hundred Twenty-four Laparoscopic-Assisted Vaginal Hysterectomies

Laparoscopic-assisted vaginal hysterectomy (LAVH) is not yet widely practiced in Taiwan, but interest in this operation is increasing as our knowledge of operative laparoscopy expands. From October 1994 to December 1995, 124 LAVHs were performed. The endoscopic stapler divides tissues and achieves hemostasis quite easily, but its cost is a disadvantage. Kleppinger bipolar forceps for hemostasis and scissors for division are less expensive for the average hospital. Ureteral injury is a crucial issue in LAVH, and is linked to various stages of the operation. Identifying the ureter before the operation and dissecting it after division of the infundibulopelvic ligament are essential to avoid ureteral injury.