Chin-Jung Wang1, Hui-Yu Huang, Chen-Ying Huang, Hsuan Su. 1. Department of Obstetrics and Gynecology, Division of Gynecologic Endoscopy, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, 5, Fu-Hsin Street, Kwei-Shan, Tao-Yuan, Taiwan, wang2260@gmail.com.
Abstract
BACKGROUND: Natural orifice transluminal endoscopic surgery has shown its prospection as a minimally invasive endoscopic surgery. This study aimed to examine the safety and feasibility of transvaginal natural orifice transluminal endoscopic hysterectomy (tVNOTEH) for nonprolapsed uteri in the management of benign gynecological diseases. METHODS: Records were reviewed for the 147 consecutive tVNOTEH procedures between April 2011 and October 2013. Age, body mass index, number of vaginal delivery, and specimen weight were used to select comparable patient who had undergone laparoscopically assisted vaginal hysterectomy (LAVH). RESULTS: A total of 512 patients were recruited in this study (147 tVNOTEHs and 365 LAVHs, respectively). These patients were stratified into six subgroups according to the uterine weight and type of hysterectomy. There was no incidence of switching to abdominal laparatomy. Length of operation, estimated blood loss (EBL), requirement of blood transfusion, and length of postoperative stay were significantly greater in the LAVH group than in the tVNOTEH group but total hospital charges were higher in the tVNOTEH group (p < 0.001). There was no difference in overall incidence of operative complications between the two groups but more complications in LAVH for uterine weight more than 500 g (4.3 vs. 0 %, p < 0.001); this likely reflects higher hospital charges in this subgroup. Significant linear correlations of uterine weight with operating time and EBL existed in both groups. CONCLUSION: tVNOTEH can be safely performed for large and nonprolapsed uterus. Besides, as uterine weight increased, the operative efficiency of tVNOTEH increases compared with LAVH.
BACKGROUND: Natural orifice transluminal endoscopic surgery has shown its prospection as a minimally invasive endoscopic surgery. This study aimed to examine the safety and feasibility of transvaginal natural orifice transluminal endoscopic hysterectomy (tVNOTEH) for nonprolapsed uteri in the management of benign gynecological diseases. METHODS: Records were reviewed for the 147 consecutive tVNOTEH procedures between April 2011 and October 2013. Age, body mass index, number of vaginal delivery, and specimen weight were used to select comparable patient who had undergone laparoscopically assisted vaginal hysterectomy (LAVH). RESULTS: A total of 512 patients were recruited in this study (147 tVNOTEHs and 365 LAVHs, respectively). These patients were stratified into six subgroups according to the uterine weight and type of hysterectomy. There was no incidence of switching to abdominal laparatomy. Length of operation, estimated blood loss (EBL), requirement of blood transfusion, and length of postoperative stay were significantly greater in the LAVH group than in the tVNOTEH group but total hospital charges were higher in the tVNOTEH group (p < 0.001). There was no difference in overall incidence of operative complications between the two groups but more complications in LAVH for uterine weight more than 500 g (4.3 vs. 0 %, p < 0.001); this likely reflects higher hospital charges in this subgroup. Significant linear correlations of uterine weight with operating time and EBL existed in both groups. CONCLUSION:tVNOTEH can be safely performed for large and nonprolapsed uterus. Besides, as uterine weight increased, the operative efficiency of tVNOTEH increases compared with LAVH.
Authors: Jan Drahonovsky; Lucia Haakova; Michal Otcenasek; Ladislav Krofta; Eduard Kucera; Jaroslav Feyereisl Journal: Eur J Obstet Gynecol Reprod Biol Date: 2009-11-18 Impact factor: 2.435
Authors: Susanne Housmans; Nargis Noori; Supuni Kapurubandara; Jan J A Bosteels; Laura Cattani; Ibrahim Alkatout; Jan Deprest; Jan Baekelandt Journal: J Clin Med Date: 2020-12-07 Impact factor: 4.241