7 Laparoscopic hysterectomy

Wood, Carl; Maher, Peter

doi:10.1016/s0950-3552(97)80053-3

Cited by 12 publications

(7 citation statements)

References 22 publications

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“…Injury to the ureter remains the nemesis of all laparoscopic surgeons. A history of methodologies employed to date is described by Wood & Maher 14 who state that the presence of fibrosis negates the advantages of transillumination, and that dissection in the normal pelvis may still not protect the bladder and ureter close to the cervix. Indeed this was our experience when a normal routine cystoscopy and indigo carmine dye test failed to detect the sole ureteric injury.…”

Section: Discussionmentioning

confidence: 99%

Total laparoscopic tube hysterectomy: a safer option?

et al. 2000

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Objective To compare outcomes in women undergoing total laparoscopic hysterectomy performed with the assistance of a colpotomizing tube (TLTH), with those in women in whom a laparoscopically assisted hysterectomy (LAH) procedure was performed. Design A retrospective review of consecutive patients. Setting State health service patients were treated at Flinders Medical Centre, Adelaide, South Australia, and private patients were treated by the same surgeons in three private hospitals in metropolitan Adelaide. Subjects A total of 227 women who underwent operation between January 1996 and August 1999. Interventions The women involved in the first two years of this study exclusively underwent an LAH, whilst those in the latter 18 months underwent a TLTH. Main outcome measures These included intraoperative complications, including significant haemorrhage, ureteric, bladder, vascular and bowel injury; postoperative complication rates for vault infection, late bowel and ureteric injury, and miscellaneous febrile morbidity. Also documented were the operating time, nonautologous blood transfusion, operation–discharge interval, and readmission with a complication. Results The women having the TLTH procedure had significantly fewer intraoperative complications (χ2 = 8.07, P = 0.004) in comparison with the LAH group; postoperative complications were not statistically different. The mean operating times and readmission rates with surgical complications were equivalent for the two groups. The hospital stay was shorter by 1.5 days for the women having a TLTH (t = 8.39, P < 0.001), and the estimated blood loss was less than half of that for the LAH patients (t = 8.94, P < 0.001); nonautologous blood transfusion was not needed in either group. Conclusion Total laparoscopic hysterectomy utilizing the nondisposable colpotomizing tube and uterine manipulator has both fewer intraoperative complications and reduced blood loss when compared with laparovaginal hysterectomy, and is a safe alternative to LAH.

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Section: Discussionmentioning

confidence: 99%

Total laparoscopic tube hysterectomy: a safer option?

et al. 2000

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“…The main disadvantage of LAVH is the increased duration of surgery (32). Various techniques of laparovaginal surgery have been developed to reduce operating time comparable to that of an abdominal procedure (32).…”

Section: Lal'aroscopically-assisted Vaginal Hysterectomy (Lavh)mentioning

confidence: 99%

“…The development, safety, and efficacy of the laparoscopic myomectomy techniques has been established over the last 5 years (36). A small decline of 21% in use of laparotomy myomectomy between 1992 and 1997 probably dates from the increased use (23)(24)(25)(26)(27)(28)(29)(30)(31)(32). The increase in the number of vaginal hysterectomies from 17.5 to 38% of operations between 1989 and 1997 is an advantage for the patient.…”

Section: Utilization Of Laparoscopic Surgery In Australiamentioning

confidence: 99%

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The Place of Laparoscopic Surgery in Surgical Gynaecology

Wood¹,

Maher

1998

Aust NZ J Obst Gynaeco

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This review was undertaken to ascertain whether the low usage of laparoscopic surgery in gynaecology resulted from unacceptable complication rates and long operating times. The safety and efficacy of laparoscopic surgery has been compared to that of laparotomy. Reports of controlled or comparative trials of laparoscopic gynaecological surgery for adhesions, infertility, ectopic pregnancy, oophorectomy, myomectomy and laparoscopically-assisted vaginal hysterectomy (LAVH) have been reviewed between 1984 and 1997. Although further multicentre controlled trials may improve the assessment of complication rates for both laparotomy and laparoscopy procedures, laparoscopy appears to be as safe as laparotomy and generally has the advantage of shorter hospital stay and earlier return to normal activities. Except for LAVH, operating times of laparoscopic surgery are similar to that of laparotomy.

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“…8 After removal of the uterus, a gauze swab is inserted into the pouch of Douglas to prevent bowel herniation and possible damage. 8 After removal of the uterus, a gauze swab is inserted into the pouch of Douglas to prevent bowel herniation and possible damage.…”

Section: Instrument and Techniquementioning

confidence: 99%

The Gupta-Frank Clamp for Salpingo-Oophorectomy at Vaginal Hysterectomy

Gupta¹,

Frank²,

Nwosu

1998

Obstetrical & Gynecological Survey

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total number of cases performed during the initial 10 months was greater than the number of cases performed after the implementation of changes (548 compared to 518). Total maintenance cost per number of total cases per period was compared. Maintenance cost during the period before changes were implemented was $42 per case compared with $11 per case after changes were implemented, which translated into a $31 per case savings.

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7 Laparoscopic hysterectomy

Cited by 12 publications

References 22 publications

Total laparoscopic tube hysterectomy: a safer option?

Total laparoscopic tube hysterectomy: a safer option?

The Place of Laparoscopic Surgery in Surgical Gynaecology

The Gupta-Frank Clamp for Salpingo-Oophorectomy at Vaginal Hysterectomy

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