Laparoscopic assisted vaginal hysterectomy for benign uterine pathology: is it time to change?

Parkar, R.B.; Thagana, NG; Otieno, David Odhiambo

doi:10.4314/eamj.v81i5.9171

Cited by 4 publications

(5 citation statements)

References 24 publications

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“…Nine cohorts were identified, representing 40,688 women. A total of 81 bladder and 260 ureteric injuries were recorded [ 3 , 23 , 25 , 26 , 39 , 48 , 51 , 69 , 75 ]. Weighted pooled mean injury rates were 506 and 186 events per 100,000 cases respectively.…”

Section: Resultsmentioning

confidence: 99%

Systematic review of urological injury during caesarean section and hysterectomy

et al. 2022

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Introduction and hypothesis We aim to review iatrogenic bladder and ureteric injuries sustained during caesarean section and hysterectomy. Methods A search of Cochrane, Embase, Medline and grey literature was performed using methods pre-published on PROSPERO. Eligible studies described iatrogenic bladder or ureter injury rates during caesarean section or hysterectomy. The 15 largest studies were included for each procedure sub-type and meta-analyses performed. The primary outcome was injury incidence. Secondary outcomes were risk factors and preventative measures. Results Ninety-six eligible studies were identified, representing 1,741,894 women. Amongst women undergoing caesarean section, weighted pooled rates of bladder or ureteric injury per 100,000 procedures were 267 or 9 events respectively. Injury rates during hysterectomy varied by approach and pathological condition. Weighted pooled mean rates for bladder injury were 212–997 events per 100,000 procedures for all approaches (open, vaginal, laparoscopic, laparoscopically assisted vaginal and robot assisted) and all pathological conditions (benign, malignant, any), except for open peripartum hysterectomy (6,279 events) and laparoscopic hysterectomy for malignancy (1,553 events). Similarly, weighted pooled mean rates for ureteric injury were 9–577 events per 100,000 procedures for all hysterectomy approaches and pathologies, except for open peripartum hysterectomy (666 events) and laparoscopic hysterectomy for malignancy (814 events). Surgeon inexperience was the prime risk factor for injury, and improved anatomical knowledge the leading preventative strategy. Conclusions Caesarean section and most types of hysterectomy carry low rates of urological injury. Obstetricians and gynaecologists should counsel the patient for her individual risk of injury, prospectively establish risk factors and implement preventative strategies.

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Section: Resultsmentioning

confidence: 99%

Systematic review of urological injury during caesarean section and hysterectomy

et al. 2022

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“…All these factors may limit the spread of the laparoscopic approach in sub‐Saharan Africa. However, Parkar et al 13 described in 2004 the introduction of laparoscopic hysterectomy in Nairobi, Kenya and their results were comparable to other centers introducing laparoscopic surgery. Hence, some centers in sub‐Saharan Africa have managed to introduce laparoscopic hysterectomy, but currently few publications are available in this regard.…”

mentioning

confidence: 86%

“…As mentioned previously, the laparoscopic approach has been described by Parkar et al, who published two studies in 2004 and 2007. 13,16 Their studies included 149 cases (laparoscopically assisted vaginal hysterectomy, 65% of all of laparoscopically assisted vaginal hysterectomies in Kenya 2000-2003) and 112 cases (total laparoscopic hysterectomy, 85% of all cases of total laparoscopic hysterectomies in Kenya from 2000 to 2007), respectively. Both studies disclosed a hospital stay on average of two nights.…”

Section: Introductionmentioning

confidence: 99%

Is abdominal hysterectomy still the surgery of choice in sub‐Saharan Africa?

Rudnicki

Shayo

2021

Acta Obstet Gynecol Scand

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A trend toward minimally invasive surgery is increasing worldwide. However, reports on the extent and the role of vaginal or laparoscopic hysterectomy in benign gynecologic surgery in sub‐Saharan Africa are scarce. Our commentary aims to highlight the existing gaps and potential barriers to implementation of vaginal or laparoscopic hysterectomy and suggests how to introduce and expand minimally invasive gynecologic surgery in this region. Little documentation exists in the literature to account for the role of minimally invasive surgery in the sub‐Saharan Africa. Hysterectomy for benign reasons is commonly performed by the abdominal approach. This approach is accompanied by significant complications, prolonged hospitalization, and longer recovery duration. Our commentary highlights the importance of investigating region‐specific barriers to the practice of minimally invasive gynecologic surgery in sub‐Saharan Africa.

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“…Hysterectomy is the second most frequently-performed major surgical procedure among reproductive-aged women (1). Traditionally, hysterectomy is performed through the abdominal route and in the presence of significant uterine prolapse, vaginal approach has been the preferred option (2). Laparoscopy-Assisted Vaginal Hysterectomy (LAVH) has been widely reported to offer benefits such as shorter hospital stays, quicker recovery, lesser postoperative pain and lower complication rates when compared with abdominal hysterectomy hence is a viable option in patients scheduled for hysterectomy with uterine size less than 16 weeks (3).…”

Section: Introductionmentioning

confidence: 99%

First laparoscopically-assisted vaginal hysterectomy in a tertiary health facility in Abeokuta, Nigeria: A case report

Jimoh,

Ogunfunmilayo,

Waheed

et al. 2023

REJHS

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Background: Laparoscopic surgery as a form of minimal access operation has been performed for decades in the developed world, but is now gaining popularity in the developing countries including Nigeria. The recent rise in minimal access surgery in low-resource settings may be attributed to increasing expertise, growing awareness among patients and relatively reducing cost. Case report: Although laparoscopically-assisted vaginal hysterectomy (LAVH) has been documented from some centres in Nigeria, we are reporting the first case of this highly-technical surgery in our centre. Mrs. GJ was admitted with second degree uterine prolapse and had LAVH with a smooth post-operative recovery. She had reduced hospital stay as she was discharged on the first post-operative day and was satisfied with her choice of surgery as well as the outcome. There were no immediate or late post-operative complications. Conclusion: The success of this procedure further emphasize the feasibility of minimal access surgery in resource-poor settings.

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Laparoscopic assisted vaginal hysterectomy for benign uterine pathology: is it time to change?

Cited by 4 publications

References 24 publications

Systematic review of urological injury during caesarean section and hysterectomy

Systematic review of urological injury during caesarean section and hysterectomy

Is abdominal hysterectomy still the surgery of choice in sub‐Saharan Africa?

First laparoscopically-assisted vaginal hysterectomy in a tertiary health facility in Abeokuta, Nigeria: A case report

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