Total Laparoscopic Hysterectomy with Earlier Uterine Artery Ligation

Sinha, Rakesh; Sundaram, Meenakshi; Nikam, Yogesh; Hegde, Aparna; Mahajan, Chaitali

doi:10.1016/j.jmig.2008.01.012

Cited by 38 publications

(31 citation statements)

References 12 publications

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“…The procedure performed in five included studies was vaginal hysterectomy. 14,17,29,32,33 Ten of the remaining included studies assessed the odds of surgical complications following minimally invasive hysterectomy (laparoscopic-assisted vaginal hysterectomy, total laparoscopic hysterectomy, and roboticassisted hysterectomy) 16,[20][21][22][23]27,28,31,34,35 and 11 included studies assessed the odds of various types of hysterectomy including total abdominal hysterectomy and vaginal hysterectomy. 4,6,15,18,19,[24][25][26]30,36,37 Study designs of the included studies were cohort studies (24) 4,6,14-25,27-29,31-37 and case-control studies (two) 26,30 (Tables S3 and S4).…”

Section: Resultsmentioning

confidence: 99%

<p>Perioperative Complications of Hysterectomy After a Previous Cesarean Section: A Systematic Review and Meta-Analysis</p>

Rattanakanokchai¹,

Kietpeerakool²,

Srisomboon³

et al. 2019

CLEP

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Background: With increasing rates of cesarean sections (CS), the number of hysterectomies performed among women with a previous CS is on the rise. Objective: To provide the association between the odds of complications following a hysterectomy performed later in life and a previous CS. Search strategy: A comprehensive search was performed using major electronic databases, ie, MEDLINE, Scopus, ISI Web of Science, from their inception to April 2019. Selection criteria: Analytical studies, irrespective of language or publication status, were included. Data collection and analysis: Outcomes were extracted in duplicate. The methodological quality of the included studies was independently evaluated by two review authors. A threelevel meta-analysis was applied for outcomes with dependent effect sizes. Main results: Twenty-six studies were included involving 54,815 women. The odds of the following complications were increased in women with a previous CS: urinary tract injury (pooled unadjusted odds ratio (OR)=3.15, 95% CI=2.01-4.94, 15 studies, 33,902 women, and pooled adjusted OR=2.21, 95% CI=1.46-3.34, 3 studies, 31,038 women), gastrointestinal tract injury (pooled unadjusted OR=1.73, 95% CI=1.19-2.53; 7 studies, 30,050, and pooled adjusted OR=1.83, 95% CI=1.11-3.03, 1 study, 25,354 women), postoperative infections (pooled unadjusted OR=1.44, 95% CI=1.22-1.71, 6 studies, 37,832 women), wound complications (pooled unadjusted OR=2.24, 95% CI=1. 9 studies,37,559 women), reoperation (pooled unadjusted OR=1.46, 2 studies,9,899 women), and blood transfusion (pooled unadjusted OR=1.35, 95% CI=1.03-1.76, 7 studies, 13,430 women). Conclusion: Previous CS increases risks of various complications following hysterectomy. This information reminds the gynecologists to be aware of the associations between previous CS and potential complications among women undergoing hysterectomy. Prospero registration number: CRD42018085061.

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Section: Resultsmentioning

confidence: 99%

<p>Perioperative Complications of Hysterectomy After a Previous Cesarean Section: A Systematic Review and Meta-Analysis</p>

Rattanakanokchai¹,

Kietpeerakool²,

Srisomboon³

et al. 2019

CLEP

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“…The author has also reported that ligation of uterine vessels as the first step in total laparoscopic hysterectomy considerably reduces blood loss during the procedure, especially in cases of large myomas. [11]…”

Section: Introductionmentioning

confidence: 99%

Laparoscopic myomectomy with uterine artery ligation: Review article and comparative analysis

Sinha

Sundaram

Mahajan

et al. 2011

J Gynec Endosc Surg

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Uterine leiomyomas are one of the most common benign smooth muscle tumors in women, with a prevalence of 20 to 40% in women over the age of 35 years. Although many women are asymptomatic, problems such as bleeding, pelvic pain, and infertility may necessitate treatment. Laparoscopic myomectomy is one of the treatment options for myomas. The major concern of myomectomy either by open method or by laparoscopy is the bleeding encountered during the procedure. Most studies have aimed at ways of reducing blood loss during myomectomy. There are various ways in which bleeding during laparoscopic myomectomy can be reduced, the most reliable of which is ligation of the uterine vessels bilaterally. In this review we propose to discuss the benefits and possible disadvantages of ligating the uterine arteries bilaterally before performing laparoscopic myomectomy.

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“…One study of 350 women who underwent TLH indicated that performing uterine artery ligation at the beginning of TLH, rather than after cornuary pedicles as is normally the case, reduced both total blood loss and the operation time. 41 Other possible innovations include the use of vasopressin. For example, in one recent small retrospective study on five women with caesarean scar pregnancies (CSPs), the efficacy of using vasopressin injection into the myometrium to help control haemorrhage during laparoscopy, with temporary bilateral uterine artery occlusion with titanium clips at the start of the procedure, was investigated.…”

Section: Blood Lossmentioning

confidence: 99%

The Management of Gynecological Laparoscopy Complications: Review

Eser¹,

Gümüş²,

Akgün³

et al. 2017

Turkiye Klinikleri J Gynecol Obst

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A AB BS S T TR RA AC CT T Laparoscopy has a good safety profile, with advantages over more invasive surgeries such as reduced operative procedure time, reduced complications, decreased hospital stay and improved recovery time. However, complications can arise, including vessel injuries, gastrointestinal and genitourinary injury, gas embolism, incisional hernia, port site metastases, subcutaneous emphysema, wound site infection, intraperitoneal adhesions and anaesthesia related complications. Training and supervision of new surgeons, familiarity with equipment and instruments, development of excellent surgical skills and awareness of potential complications are key to management of complications in gynaecological endoscopic procedures. Importantly, there are many ways in which the risk of complications can be minimised. Laparoscopic camera control systems and robotically assisted endoscopic surgeries are some recently developed technological innovations. The use of laparo-endoscopic single-site surgery for procedures including balloon vaginoplasty should theoretically also help reduce complications. There is also a trend towards natural orifice transluminal endoscopic surgery, for example, transvaginal natural orifice transluminal endoscopic hysterectomy, which has the advantages of not being limited by uterine volume or the need for abdominal incision. Thus, surgeons can incorporate innovative techniques and technologies into management and minimisation of complications in gynaecological endoscopic procedures. This article reviews measures can be taken to minimize and management of gynecological laparoscopic complications.K Ke ey yw wo or rd ds s: : Laparoscopy; complications; case management Ö ÖZ ZE ET T Laparoskopi daha invaziv cerrahiler üzerine, daha kısa operasyon süresi, azalan komplikasyonlar, daha kısa hastanede kalış süresi, daha hızlı iyileşme gibi avantajlarıyla iyi bir güvenlik profiline sahiptir. Ancak damar yaralanmaları, gastrointestinal ve genitoüriner yaralanmalar, gaz embolisi, insizyonel herni, port yeri metastazı, subkutanöz anfizem, yara yeri enfeksiyonu, intraperitoneal adezyonlar ve anestezi ile ilişkili istenmeyen olaylar gibi komplikasyonlar meydana gelebilmektedir. Yeni cerrahların eğitilmesi ve denetlenmesi, araç gereçleri tanımaları, kusursuz cerrahi yetenekler geliştirmeleri ve potansiyel komplikasyonlara dair bilince sahip olmaları jinekolojik endoskopik yöntemlerde komplikasyon yönetiminin anahtarlarıdır. Daha da önemlisi, komplikasyon riskini minimize edebilmenin birçok yolu bulunmaktadır. Laparaskopik kamera kontrol sistemleri ve robotik yardımlı endoskopik ameliyatlar geliştirilen güncel teknolojik yeniliklerden bazılarıdır. Balon vajinoplasti gibi yöntemler için laparo-endoskopik tek taraflı cerrahi uygulaması da teorik olarak komplikasyonların azaltılmasına yardımcı olur. Aynı zamanda, örne-ğin vajinal histerektomi gibi uterus hacminin sınırlandırıcı etkisinin olmaması veya abdominal kesi gerektirmeme gibi avantajlara sahip olması nedeniyle transluminal endoskopik cerrahiye do...

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Total Laparoscopic Hysterectomy with Earlier Uterine Artery Ligation

Cited by 38 publications

References 12 publications

<p>Perioperative Complications of Hysterectomy After a Previous Cesarean Section: A Systematic Review and Meta-Analysis</p>

<p>Perioperative Complications of Hysterectomy After a Previous Cesarean Section: A Systematic Review and Meta-Analysis</p>

Laparoscopic myomectomy with uterine artery ligation: Review article and comparative analysis

The Management of Gynecological Laparoscopy Complications: Review

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