Total Laparoscopic Hysterectomy: Indications, Techniques and Outcomes

Williams, Jeyakumar

doi:10.5005/jp/books/10476_5

Cited by 5 publications

(5 citation statements)

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“…13 In the present study, the mean age of patients in TAH group was 43 yrs and in LAVH group it was 45.2 yrs. This is comparable to studies done by Wu [17][18][19][20] In the present study, mean uterine size in gestational weeks was 8.8 in TAH and 7.2 in LAVH and this is comparable to study of Kulvanitchaiyanunt A which had 7.8 weeks in NDVH as compared to 6.9 weeks in TAH group. 21 In this study, fibroids were the most common indication in both groups and DUB was the second most common indication in both groups.…”

Section: Discussionsupporting

confidence: 91%

Comparative study of intra and post-operative complications between total abdominal hysterectomy and laparoscopic assisted vaginal hysterectomy

Priya

Allirathnam

et al. 2019

Int J Reprod Contracept Obstet Gynecol

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Background: Vaginal hysterectomy is preferable due to faster recovery, decreased morbidity and absence of an abdominal incision. The aim was to compare the risks and complications of laparoscopy assisted vaginal hysterectomy and total abdominal hysterectomy in terms of intra-operative and post-operative complications.Methods: A retrospective observational study was conducted in the Gynaecology ward at Vinakaya Mission’s Kirupananda Variyar Medical College and Hospitals, Salem, Tamil Nadu, India. The data for the past 1-year record was taken for analysis. A total of 80 subjects were included in the study and were divided into two groups with 40 patients under TAH (total abdominal hysterectomy) group and 40 under LAVH (Laproscopic assisted vaginal hysterectomy) group. The primary outcome of the present analysis was incidence of perioperative complications like blood loss and the secondary outcomes were operating time, blood loss, urinary tract injury, rate of conversion to laparotomy, postoperative pain, and length of postoperative stay.Results: The mean intra-operative blood loss was measured among both the groups and it was found to be very high among TAH group (201 ml) compared to LAVH group (149.8 ml) and the difference was found to be statistically significant (p <0.05). Similarly, the duration of operative procedure was found to be less in LAVH group (57.9 mins) compared to TAH group (72.6 mins) and the difference was found to be statistically significant (p <0.05). Post-operative wound infection (14 vs 0) was found to be more among the patients in TAH group than that of the LAVH group and the difference was found to be statistically significant (p <0.05).Conclusions: LAVH is a safe and effective surgical treatment for benign gynaecological diseases and should be offered whenever possible, taking into account the low rate of complications and cost-effectiveness.

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Section: Discussionsupporting

confidence: 91%

Comparative study of intra and post-operative complications between total abdominal hysterectomy and laparoscopic assisted vaginal hysterectomy

Priya

Allirathnam

et al. 2019

Int J Reprod Contracept Obstet Gynecol

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“…Severe adhesion cases can be so long and time consuming that the surgeon makes no progress and converts to a laparotomy. 7 In this study, although majority of women had not undergone any surgery in the past, there were 49 women with previous 1 LSCS, 16 women with previous 2 LSCS and 8 cases with more than 2 previous LSCS.…”

Section: Discussionmentioning

confidence: 72%

Laparoscopic assisted vaginal hysterectomy: an experience at a Fortis Escorts hospital

Rajput

Yadav

Narwade

2020

Int J Reprod Contracept Obstet Gynecol

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Background: The objective of this study was to evaluate the laparoscopic assisted vaginal hysterectomy (LAVH) in terms of demographic data of patients, indications, uterine size, intraoperative and postoperative complications, amount of blood loss, operative time and duration of hospital stay.Methods: A retrospective study was conducted on 160 cases, who underwent laparoscopic assisted vaginal hysterectomy in the period between October 2018 to November 2019 at the Fortis Escorts Hospital, Faridabad, Haryana, India.Results: Majority of patients (58.75%) belongs to age group between 40-50 year. Only 30.62% cases had a history of one previous abdomino-pelvic surgery. Majority of cases (52.5%) in the study group had uterine size between 6-12 weeks. Most common indication of hysterectomy in this study was fibroid uterus which account for 49.37% of cases followed by dysfunctional uterine bleeding (16.87%) cases. Mean time of surgery in this study was 114.4±0.59 min and average blood loss was 135.62±47.63 ml. The mean weight of uterus was 243.75±82.94 gm. 5% cases had major intraoperative complications while minor postoperative complications were seen in 16.87% cases. Bladder injury was seen in 1.25%. Major haemorrhage occur in 1.25%. In this study conversion to laparotomy rate was 1.25%. Only one case of ureteric injury and one case of bowel injury was noted. Among minor complications fever (6.25%) and urinary tract infection (5.62%) were mainly seen. Mean duration of hospital stay was 2.82±1.17 days.Conclusions: LAVH enables the surgeon to convert most of the abdominal hysterectomies into vaginal ones and hence decreases postoperative pain, decreases complications, lesser duration of hospital stay and rapid return to normal activity.

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“…Historically, the first laparoscopically assisted vaginal hysterectomy was described in 1989 by Reich et al (27) and in the same year Dargent and Salvat published the first report for laparoscopically pelvic node dissection for cervical cancer (28). Two years later, the first studies of common iliac and paraaortic lymph node dissection for endometrial cancer were published (29,30) and more recently total laparoscopic hysterectomy without vaginal approach was described (31). In 1999, the Da Vinci robotic surgery system was developed and in 2005 Reynolds described the first case series of robotic total hysterectomies with bilateral salpingooophorectomy and pelvic lymphadenectomy for endometrial cancer (32).…”

Section: Surgical Approachmentioning

confidence: 99%

Recent management of endometrial cancer: a narrative review of the literature

Pados,

Zouzoulas,

Tsolakidis

2024

Front. Med.

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Endometrial cancer is a common female gynecological neoplasia and its incidence rate has increased in the past years. Due to its predominant symptoms, most women will present uterine bleeding. It is usually diagnosed at an early stage and surgery has an important role in the treatment plan. The prognosis and quality of life of these patients can be quite favorable, if proper treatment is offered by surgeons. Traditionally, more invasive approaches and procedures were offered to these patients, but recent data suggest that more conservative and minimal invasive choices can be adopted in the treatment algorithm. Minimal invasive surgery, such as laparoscopy and robotic surgery, should be considered as an acceptable alternative, compared to laparotomy with less comorbidities and similar oncological and survival outcomes. Furthermore, sentinel lymph node biopsy has emerged in the surgical staging of endometrial cancer, in order to replace comprehensive lymphadenectomy. It is associated with less intra- and postoperative complications, while preliminary data show no difference in survival rates. However, sentinel lymph node biopsy should be offered within a strict algorithm, to avoid residual metastatic disease. The aim of this review is to analyze all the available data for the application of minimal invasive surgery in early endometrial cancer and especially the role of sentinel lymph node biopsy.

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Total Laparoscopic Hysterectomy: Indications, Techniques and Outcomes

Cited by 5 publications

References 0 publications

Comparative study of intra and post-operative complications between total abdominal hysterectomy and laparoscopic assisted vaginal hysterectomy

Comparative study of intra and post-operative complications between total abdominal hysterectomy and laparoscopic assisted vaginal hysterectomy

Laparoscopic assisted vaginal hysterectomy: an experience at a Fortis Escorts hospital

Recent management of endometrial cancer: a narrative review of the literature

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