Clinical Evaluation on 30 cases of Laparoscopically Assisted Vaginal Hysterectomy for Uteri Weighing 500 g or more / 대한산부인과학회지

OBJECTIVE: To determine the feasibility and safety of performing laparoscopically assisted vaginal hysterectomy (LAVH) for uteri weighing 500 g or more and evaluate the advantages and complications of LAVH. METHODS: A subpopulation of 30 women with uteri weighing 500 g or more from group of 412 patients undergoing LAVH between Mar, 2003 to Feb, 2005. We reviewed medical records and analyzed these cases about age, parity, history of previous abdominal surgery, preoperative indications, postoperative pathologic diagnosis, mean operation times, weight of extracted uterus, change of hemoglobin, hospital stay, and complications. RESULTS: The mean age was 44.8+/-3.88 years. The mean parity was 1.78+/-0.76. Previous operation history was 16 cases (53.3%). The most common indication of operation was palpable abdominal mass. The most common pathologic diagnosis was leiomyoma. The mean operation time was 126.40+/-39.30 minutes. The mean weight of uterus was 621.23+/-107.28 g. The mean hemoglobin change was 1.57+/-1.14 g/dL. The mean hospital stay was 3.74+/-0.88 days. The only complication of operation was superficial trocar site bleeding (1 case). CONCLUSION: LAVH is a safe and effective alternative to total abdominal hysterectomy of the uteri weighing 500 g or more in selective groups.

Clinical Evaluation on 154 Cases of Laparoscopically Assisted Vaginal Hysterectomy (LAVH) / 대한산부인과학회잡지

OBJECTIVE: To evaluate the indications, advantages and complications of laparoscopically assisted vaginal hysterectomy (LAVH), retrospectively. METHODS: From Mar. 2003 to Feb. 2004, clinical trials of LAVH (n=154) were performed in the Department of Obstetrics and Gynecology, Kangbuk Samsung Medical Center, School of Medicine, University of Sungkyunkwan, Seoul, Korea. Medical records of patients who underwent LAVH were reviewed. The results were evaluated according to characteristics of patients, history of previous abdominal surgery, preoperative surgical indications, postoperative diagnosis, mean operation times, weight of uterus, change of hemoglobin, hospital stay, associated diseases, concomitant procedures and complications. RESULTS: The mean age was 46.09 +/- 6.67 years. The mean parity was 2.08 +/- 0.94. Tubal ligation, vaginal bleeding, leiomyoma was the most common previous abdominal surgery, preoperative surgical indication, and postoperative diagnosis, respectively. The mean operation time was 130.66 +/- 67.68 minutes. The mean uterine weight was 259.27 +/- 123.48 gm. The mean hemoglobin change was 1.61 +/- 1.12 g/dL. The mean hospital stay was 3.44 +/- 1.83 days. The complication rate was 3.2% (5 cases); bladder injury (3 cases) being the most common complication. CONCLUSION: LAVH appears to be beneficial in many aspects. The further development of laparoscopic instruments and skills will reduce limitations and complications of LAVH and will hopefully allow the utilization of this technique to expand to include other clinical indications and concomitant procedures.