Total laparoscopic hysterectomy with suture technique

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Abstract

Objective

To evaluate the efficacy of total laparoscopic hysterectomy (TLH) with suture technique.

Design

Review of hospital records of 108 women who underwent total laparoscopic hysterectomy between January 1 1994 and December 31 1996.

Setting

Department of obstetrics and gynaecology at a university teaching hospital.

Subjects

108 women who underwent total laparoscopic hysterectomy.

Interventions

All the hysterectomy procedures were performed in the classic manner, with scissors, grasping forceps, bipolar coagulation and suture technique as in total abdominal hysterectomy (TAH).

Main outcome measures and results

Indications, patient characteristics, associated procedures, surgical outcomes, and complications were analysed. The mean age of the patients was 44.7 ± 5.0 years. The most common surgical indication was squamous intraepithelial lesion of the cervix, including carcinoma in situ and dysplasia. The mean operating time was 173.4 ± 80.4 min, and blood loss (189 ± 105 ml) was lower than that of conventional abdominal hysterectomy. Mean uterine weight was 87.3 ± 24.3 g. None of the procedures was converted to laparotomy. There were no intraoperative complications, and a few postoperative complications were noted, specifically three out of 108 cases, comprising 2.8%. The complications included two vaginal vault infections and a febrile condition.

Conclusions

Our findings suggest that total laparoscopic hysterectomy with a suture technique is feasible, cost-effective, safer than, and a good alternative to, abdominal and vaginal hysterectomy.

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