Vaginal hysterectomy is made easier with ERBE Biclamp® forceps

Chia, K. V.; Tandon, S; Moukarram, H

doi:10.1080/01443610701612789

Cited by 12 publications

(17 citation statements)

References 3 publications

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“…Similar to the current authors' findings, electrosurgery has been reported to be safe in vaginal hysterectomy by many studies, 6,13,[18][19][20][21] when this technique is applied carefully. Accessibility to pedicles was increased by using a right-angle forceps 6 in this procedure.…”

Section: Discussionsupporting

confidence: 79%

Vaginal Hysterectomy by Electrosurgery for Benign Indications Associated with Previous Cesarean Section

Purohit¹,

Sharma²,

Singh³

et al. 2013

Journal of Gynecologic Surgery

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Background: Vaginal hysterectomies have been associated with difficulties in patients who have had cesarean sections prior to such hysterectomies. However, the Purohit technique may obviate the problems and make it easier to perform these operations. Objectives: This research tested an approach designed to facilitate vaginal hysterectomy in patients with previous cesarean sections in the absence of fixed adhesions of uterine corpi to previous anterior abdominal scarring. Design/Method: An observational study was conducted in a private general hospital between February 2010 and June 2012. All candidates for hysterectomy for benign indications who had had previous cesarean sections were examined for the presence of clinical and sonographic signs of fixed adhesions of uterine corpi to anterior abdominal-wall incisions caused by prior cesarean sections. Candidates who had such adhesions were not given vaginal hysterectomies. Results: Sixty-four (64) consecutive candidates were selected for vaginal hysterectomies. Of these patients, 26 (40.62%) had 1 cesarean section, 33 (51.56 %) had 2 cesarean sections, and 5 (7.81%) had 3 cesarean sections. Four (4) patients had had prior pelvic operations. The uteri were smaller than 12 weeks' gestationsize in 62 (96.87%) cases. In 26 (40.62 %) cases, there were no obstruction to accessing the anterior cul-de-sacs and vaginal hysterectomies were performed using the Purohit technique. In 38 (59.37 %) cases, dense uterovesical adhesions obstructed access to the anterior cul-de-sacs and a posterioanterior approach was used to perform vaginal hysterectomy in these patients. Vaginal hysterectomy was completed in all 64 cases. Vaginal salpingo-oophorectomy was performed in 3 (4.68%) cases. The mean operative time was 78. 59 -33.15 (35-190) minutes. The mean weight of specimen uteri was 161.01 -108.87 (50-550) g. No patients needed conversions or blood transfusions. No patients had bladder, ureteric, or thermal injuries. Finally, there were no other major postoperative complications. Conclusions: In the absence of fixed adhesions of the uterine corpus to previous anterior abdominal scarring, vaginal hysterectomy for benign indications associated with previous cesarean section may be accomplished safely. The posterioanterior approach during vaginal hysterectomy may avoid unintended bladder injury in the presence of dense uterovesical adhesions caused by previous cesarean sections. ( J GYNECOL SURG 29:7)

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Section: Discussionsupporting

confidence: 79%

Vaginal Hysterectomy by Electrosurgery for Benign Indications Associated with Previous Cesarean Section

Purohit¹,

Sharma²,

Singh³

et al. 2013

Journal of Gynecologic Surgery

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“…This snapshot of mode of delivery following a previous CS reports outcomes similar to the national study of Knight et al 2 …”

supporting

confidence: 63%

“…The routine use of patient-controlled anaesthesia (PCA) does not encourage the day case approach, at a time when vaginal hysterectomy is being seen as a day case procedure. 2 The fluid may cause pain by irritation to the peritoneum, make it difficult to diagnose intraperitoneal bleeding and lead to leakage of fluid through the vaginal vault. The use of a drain in the presence of such irrigation is interesting.…”

Section: Authors' Replymentioning

confidence: 99%

“…Indeed, such pumps have been shown to both increase ambulation and decrease hospital stay. [1][2][3] Similarly, the use of patient-controlled anaesthesia (PCA) following laparoscopic surgery has been shown to enhance mobility and decrease hospital length of stay. 4 From a study design perspective, we opted to use PCA as it provided an objective measure of the quantity of analgesic used.…”

mentioning

confidence: 99%

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Continuous infusion of local anaesthetic following laparoscopic hysterectomy: a randomised controlled trial

Ismail

2014

BJOG

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“…In den USA [19] und in England beträgt das Verhält-nis abdominaler zu vaginaler HE 3:1 [4]. Verantwortlich dafür werden unter anderem die Ausbildung der Assistenten und die fehlende Information der Patientinnen über mögliche chirurgische Alternativen gemacht [19].…”

Section: Wahl Des Operationswegesunclassified

Vaginale und abdominale Hysterektomie

et al. 2008

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Vaginale und abdominale Hysterektomie Leitthema Einer der Basiseingriffe in der Gynäko-logie ist die Hysterektomie (HE), für die es drei verschiedene Zugangswege und eine Reihe von verschiedenen Operationstechniken gibt. Im Jahr 2005 wurden laut der Statistik der Bundesgeschäftsstel-le Qualitätssicherung (BQS) -diese ermittelt seit 2001 systematisch die medizinische und pflegerische Behandlungsqualität der Krankenhäuser in Deutschland -132.314 HE durchgeführt. Davon wurden 54% vaginale, 43% abdominale und nur 3% laparoskopisch assistierte vaginale HE vorgenommen [25]. Die vaginale HE gilt im Vergleich zur abdominalen HE als der schonendere Eingriff, die Entwicklung neuer Operationsinstrumente beschleunigt zudem die postoperative Rekonvaleszenz. > Neue Operationsinstrumente beschleunigen die postoperative Rekonvaleszenz Das vaginale Entfernen des Uterus lässt sich bereits in die Antike zurückverfolgen. Historischen Berichten zufolge wurde die Operation bereits im Jahre 120 v. Chr. durch Soranus von Ephesus durchgeführt. Die erste vaginale HE der Gegenwart wurde 1813 von Langenbeck, die erste abdominale HE von Charles Clay 1863 in Manchester/England durchgeführt und von Pfannenstiel in den 1920er-Jahren durch die Einführung des Transversalschnitts modernisiert [27]. Die HE ist weltweit einer der häu-figsten gynäkologischen Eingriffe [32], die Rate hat sich in den letzten 15 Jahren nicht verändert. In den USA werden pro Jahr etwa 600.000 HE durchgeführt [34].Es existieren im Prinzip drei verschiedene Methoden -abdominal, vaginal und laparoskopisch. Die laparoskopische Uterusexstirpation wiederum lässt sich weiter differenzieren in laparoskopisch assistierte HE (LAVH), laparoskopisch assistierte suprazervikale HE (LASH) und totale laparoskopische HE (TLH).Die vaginale HE zählt zu den Standardverfahren in der operativen Gynäko-logie und wurde ursprünglich beim Prolaps uteri durchgeführt. Zum einen wird sie als eigenständiger Eingriff, zum anderen im Rahmen anderer gynäkologischer Operationsverfahren angewandt. Sie ist weniger invasiv als eine abdominale HE.

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Vaginal hysterectomy is made easier with ERBE Biclamp® forceps

Cited by 12 publications

References 3 publications

Vaginal Hysterectomy by Electrosurgery for Benign Indications Associated with Previous Cesarean Section

Vaginal Hysterectomy by Electrosurgery for Benign Indications Associated with Previous Cesarean Section

Continuous infusion of local anaesthetic following laparoscopic hysterectomy: a randomised controlled trial

Vaginale und abdominale Hysterektomie

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