A prospective randomized comparison of vaginal hysterectomy, laparoscopically assisted vaginal hysterectomy, and total laparoscopic hysterectomy in women with benign uterine disease

Drahonovsky, Jan; Haaková, L.; Otčenášek, M; Krofta, Ladislav; Kucera, E; Feyereisl, Jaroslav

doi:10.1016/j.ejogrb.2009.10.019

Cited by 89 publications

(68 citation statements)

References 21 publications

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“…But the p value for comparison of this parameter is 0.0915 which is not statistically significant. This is consistent with most of the studies that have been done so far as also Drahonovsky J, et al 3 The average pain recorded after the 3 rd hour of surgery for NDVH was 9.52, while that for TLH was 9. The P value is 0.0128 which is statistically significant.…”

Section: Post-operative Complicationssupporting

confidence: 92%

“…2 In India approximately 2,310,263 women undergo hysterectomy every year. 3 Most of these women hail from rural sides, belong to the working class and are financially challenged. Keeping this demographic profile of Indian population in mind, it is important that the procedure of hysterectomy for Indian population should be cost-effective and with minimum duration of hospital stay.…”

Section: Introductionmentioning

confidence: 99%

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A comparative study of total laparoscopic hysterectomy and non-descent vaginal hysterectomy for treatment of benign diseases of uterus

Chattopadhyay

Patra

Halder

et al. 2017

Int J Reprod Contracept Obstet Gynecol

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Background: Hysterectomy is the most common performed major gynaecological surgery and the decision depends on indications for operation, surgeon’s training and preference, uterine size, adnexal pathologies and patient choice. To avoid laparotomy either total laparoscopic hysterectomy (TLH) or non-descent vaginal hysterectomy (NDVH) is the recently practised option. Objectives of the present study are to compare duration of operation, blood loss, ambulation time, post-operative pain and complications between TLH and NDVH.Methods: Patients undergoing above operation during January 2014 to December 2014 at N.R.S. Medical College, Kolkata, were included under the study. All patients were thoroughly examined and investigated and malignancies were excluded by Pap smear and or D&C. All patients were observed minutely during pre-operative, intra operative and post-operative period for any complications.Results: NDVH requires less operative time than TLH but intra operative blood loss, post-operative pain and ambulation time are slightly more.Conclusions: TLH requires infrastructural set up, greater surgical expertise, longer operative time and major intraopertive complications as compared to NDVH. In our low resource government hospital NDVH is better choice for removal of uterus in uncomplicated benign conditions.

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Section: Post-operative Complicationssupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

A comparative study of total laparoscopic hysterectomy and non-descent vaginal hysterectomy for treatment of benign diseases of uterus

Chattopadhyay

Patra

Halder

et al. 2017

Int J Reprod Contracept Obstet Gynecol

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“…Drahonovsky et al [15] showed in their randomized prospective comparative study of vaginal hysterectomy (VH), LAVH, and TLH that LAVH resulted in a lower consumption of analgesics than TLH or VH. Kim et al [10] evaluated the postoperative pain with the use of LAVH, whereas the authors performed TLH.…”

Section: Discussionmentioning

confidence: 99%

A randomized prospective study of single-port and four-port approaches for hysterectomy in terms of postoperative pain

et al. 2011

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“…At the same time, restricted working space can make laparoscopic dissection steps difficult and result in longer operating time, potentially increasing the risk of complications 12,13 . Accordingly, the use of neuromuscular blockade to enable greater working space with lower insufflation pressure can simultaneously address two of the major source of concern for laparoscopic procedures.…”

Section: Discussionmentioning

confidence: 99%

Deep Neuromuscular Blockade Leads to a Larger Intraabdominal Volume During Laparoscopy

Lindekær

Springborg

Istre

2013

JoVE

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Shoulder pain is a commonly reported symptom following laparoscopic procedures such as myomectomy or hysterectomy, and recent studies have shown that lowering the insufflation pressure during surgery may reduce the risk of post-operative pain. In this pilot study, a method is presented for measuring the intra-abdominal space available to the surgeon during laproscopy, in order to examine whether the relaxation produced by deep neuromuscular blockade can increase the working surgical space sufficiently to permit a reduction in the CO 2 insufflation pressure. Using the laproscopic grasper, the distance from the promontory to the skin is measured at two different insufflation pressures: 8 mm Hg and 12 mm Hg. After the initial measurements, a neuromuscular blocking agent (rocuronium) is administered to the patient and the intraabdominal volume is measured again. Pilot data collected from 15 patients shows that the intra-abdominal space at 8 mm Hg with blockade is comparable to the intra-abdominal space measured at 12 mm Hg without blockade. The impact of neuromuscular blockade was not correlated with patient height, weight, BMI, and age. Thus, using neuromuscular blockade to maintain a steady volume while reducing insufflation pressure may produce improved patient outcomes. Video LinkThe video component of this article can be found at

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A prospective randomized comparison of vaginal hysterectomy, laparoscopically assisted vaginal hysterectomy, and total laparoscopic hysterectomy in women with benign uterine disease

Cited by 89 publications

References 21 publications

A comparative study of total laparoscopic hysterectomy and non-descent vaginal hysterectomy for treatment of benign diseases of uterus

A comparative study of total laparoscopic hysterectomy and non-descent vaginal hysterectomy for treatment of benign diseases of uterus

A randomized prospective study of single-port and four-port approaches for hysterectomy in terms of postoperative pain

Deep Neuromuscular Blockade Leads to a Larger Intraabdominal Volume During Laparoscopy

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