Total Laparoscopic Hysterectomy with Earlier Uterine Artery Ligation

2008 ◽  
Vol 15 (3) ◽  
pp. 355-359 ◽  
Author(s):  
Rakesh Sinha ◽  
Meenakshi Sundaram ◽  
Yogesh A. Nikam ◽  
Aparna Hegde ◽  
Chaitali Mahajan
2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Vidyashree Ganesh Poojari ◽  
Vidya Vishwanath Bhat ◽  
Ravishankar Bhat

We compared the duration of surgery, blood loss, and complications between patients in whom both uterine arteries were ligated at the beginning of total laparoscopic hysterectomy (TLH) and patients in whom ligation was done after cornual pedicle. Using a prospective study in a gynecologic laparoscopic center, a total of 52 women who underwent TLH from June 2013 to January 2014 were assigned into two groups. In group A, uterine arteries were ligated after the cornual pedicles as done conventionally. In group B, TLH was done by ligating both uterine arteries at the beginning of the procedure. All the other pedicles were desiccated using harmonic scalpel or bipolar diathermy. Uterus with cervix was removed vaginally or by morcellation. The indication for TLH was predominantly dysfunctional uterine bleeding and myomas in both groups. In group A, the average duration of surgery was 71 minutes, when compared to 60 minutes in group B(P<0.001). In group A, the total blood loss was 70 mL, when compared to 43#x2009;mL in group B (Pvalue < 0.001). There were no major complications in both groups. To conclude, prior uterine artery ligation at its origin during TLH reduces the blood loss and surgical duration as well as the complications during surgery.


2010 ◽  
Vol 2010 ◽  
pp. 1-10 ◽  
Author(s):  
Michail S. Papadopoulos ◽  
Athanasios C. Tolikas ◽  
Dimosthenis E. Miliaras

Hysterectomy is the commonest gynecologic operation performed not only for malignant disease but also for many benign conditions such as fibroids, endometrial hyperplasia, adenomyosis, uterine prolapse, dysfunctional uterine bleeding, and cervical intraepithelial neoplasia. There are many approaches to hysterectomy for benign disease: abdominal hysterectomy, vaginal hysterectomy, laparoscopic assisted vaginal hysterectomy (LAVH) where a vaginal hysterectomy is assisted by laparoscopic procedures that do not include uterine artery ligation, total laparoscopic hysterectomy (TLH) where the laparoscopic procedures include uterine artery ligation, and subtotal laparoscopic hysterectomy (STLH) where there is no vaginal component and the uterine body is removed using a morcelator. In the last decades, many new techniques, alternative to hysterectomy with conservation of the uterus have been developed. They use modern technologies and their results are promising and in many cases comparable with hysterectomy. This paper is a review of all the existing hysterectomy techniques and the alternative methods for benign indications.


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