Vaginal hysterectomy in the absence of prolapse

Olàh, Karl S.

doi:10.1576/toag.7.4.233.27117

Cited by 8 publications

(5 citation statements)

References 56 publications

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“…Yet, less vaginal hysterectomy is performed compared with abdominal hysterectomy and the estimated ratio of vaginal to abdominal hysterectomy in the UK is 1:3 (Olah 2005). The most common reasons given for opting for an abdominal route are no uterine descent, large bulky uterus, fibroids, need for oophorectomies, and previous pelvic surgery.…”

Section: Introductionmentioning

confidence: 99%

Vaginal hysterectomy is made easier with ERBE Biclamp® forceps

Chia

Tandon

Moukarram

2007

Journal of Obstetrics and Gynaecology

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The ratio of vaginal hysterectomy to abdominal hysterectomy in the UK is 1:3. It is well known that patients who have had a vaginal hysterectomy recover better compared with abdominal hysterectomy. However, abdominal hysterectomy is the preferred method in most hospitals because it is deemed easier to do. With ERBE Biclamp diathermy forceps, vaginal hysterectomy could be safely and easily performed by gynaecologists. This study showed a different surgical technique for performing vaginal hysterectomy. It allowed easier and safer operations in patients with large uterus, fibroid uterus, where there was no uterine descent and narrow introitus. Also it allowed the adnexal appendages to be removed easily by the vaginal route. We compared 100 patients who had a vaginal hysterectomy performed using this method, with patients who had a vaginal hysterectomy performed by the conventional method using sutures. We found that we could safely perform vaginal hysterectomy with greater ease. Also, the need for postoperative analgesia was less and the patients were discharged earlier. Consequently, the patients' convalescence period was shorter and better.

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Section: Introductionmentioning

confidence: 99%

Vaginal hysterectomy is made easier with ERBE Biclamp® forceps

Chia

Tandon

Moukarram

2007

Journal of Obstetrics and Gynaecology

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“…Use of vasopressors during vaginal hysterectomy can give a false sense of security and may contribute to the development of vault haematoma. 10 This technique can be considered as a modification of the original Purohit technique where all stumps are cauterized and divided. Most NDVH fail because of failure to divide the uterosacral and cardinal ligaments.…”

Section: Discussionmentioning

confidence: 99%

Selective cauterization of supporting ligaments at Non Descent Vaginal Hysterectomy (NDVH)

Nambiar

Pai

Poojari

et al. 2017

Int J Reprod Contracept Obstet Gynecol

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INTRODUCTIONHysterectomy is a most commonly performed gynaecological operation. Abdominal and laparoscopic route of hysterectomy are associated with higher costs. 1 Most hysterectomies can be completed with vaginal route. However currently only 25-30 percent of them performed vaginally.2 It is a well-established fact that vaginal hysterectomy has less complications and a better post-operative out outcome.3-5 Purohit R has devised a technique where all stumps are secured by means of electrocautery.6 Sheth S has suggested that NDVH can be in done all situations like previous caesarean section and larger uteri. 7 We slightly modified this technique and used electrocautery only for cardinal uterosacral ligament complex. Use of electrocautery for all stumps may cause more charring and tissue destruction. There can be lateral spread of the electrocautery effect and may result in more tissue damage. 8 We selectively used electrocautery for securing cardinal uterosacral ligament complex. We feel division of cardinal uterosacral ligament complex is the most difficult step in vaginal hysterectomy. Once this is done NDVH becomes easier. We present a new technique where in only uterosacral ligaments are divided after electrocauterization. We have done 21 cases of NDVH using this technique with no complications. METHODSWe did a prospective observational study among patients undergoing NDVH using this new technique. Only cases where uterine size is less than 14 weeks of pregnant uterus entered the study. Before surgery a per speculum examination was done and if cervix was visualized easily they entered the study. Cases where cervix was not easily visualized were excluded from the study. The procedure for hysterectomy consisted of the following• After putting a vaginal speculum, Cervix pulled with a vulsellum. We did not infiltrate saline adrenaline around the cervix • Vaginal walls were incised both anteriorly and posteriorly with small transverse incision • Bladder dissected of the cervix ABSTRACT Background: The objective of the study was to study the use of electrocautery selectively for cardinal uterosacral ligament complex during NDVH. Methods: We performed a series of NDVH where electrocautery was used selectively for the uterosacral cardinal ligament complex. Rest all stumps were clamped, divided and ligated. Results: We did a series of 21 cases using this technique and found this as a very effective method of doing NDVH. There were no major complications. Conclusion: Selective use of electrocautery for uterosacral and cardinal ligament complex makes NDVH easy.

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“…We read with interest the article on the principles and practice of consent by Nick Nicholas and Mohammed El Sayed. 1 We would like to suggest a new development that appears to enhance the process of written consent.…”

Section: Dear Sirmentioning

confidence: 99%