H Ben-Hur1, J H Phipps. 1. Department of Obstetrics, Kaptan Medical Center, Rehovot 76100, Israel.
Abstract
STUDY OBJECTIVE: To determine the soundness of laparoscopic hysterectomy compared with vaginal and abdominal hysterectomy Design. Nonrandomized, uncontrolled, retrospective study (Canadian Task Force classification III). SETTING: Medium-size community hospitals. PATIENTS: One thousand six hundred forty-eight women undergoing laparoscopic hysterectomy, including those with uterine size 17 weeks' gestation or less. INTERVENTION: Laparoscopic hysterectomy staged as level 4, which includes laparoscopic dissection of the uterine artery. MEASUREMENTS AND MAIN RESULTS: The median duration of surgery was 36 minutes (range 24-104 min), compared with the usual 115 minutes for laparoscopic-assisted vaginal hysterectomy. Complication rate was 0.66%. No complications occurred in the last 3 years when the procedures included transillumination of the ureters. Although the costs associated with disposable equipment are high, the technique is cost effective. CONCLUSION: With proper training and ureteral transillumination, laparoscopic hysterectomy is safe and effective, and with stents, ureteral injury is avoided.
STUDY OBJECTIVE: To determine the soundness of laparoscopic hysterectomy compared with vaginal and abdominal hysterectomy Design. Nonrandomized, uncontrolled, retrospective study (Canadian Task Force classification III). SETTING: Medium-size community hospitals. PATIENTS: One thousand six hundred forty-eight women undergoing laparoscopic hysterectomy, including those with uterine size 17 weeks' gestation or less. INTERVENTION: Laparoscopic hysterectomy staged as level 4, which includes laparoscopic dissection of the uterine artery. MEASUREMENTS AND MAIN RESULTS: The median duration of surgery was 36 minutes (range 24-104 min), compared with the usual 115 minutes for laparoscopic-assisted vaginal hysterectomy. Complication rate was 0.66%. No complications occurred in the last 3 years when the procedures included transillumination of the ureters. Although the costs associated with disposable equipment are high, the technique is cost effective. CONCLUSION: With proper training and ureteral transillumination, laparoscopic hysterectomy is safe and effective, and with stents, ureteral injury is avoided.