scholarly journals Hysterectomy—Current Methods and Alternatives for Benign Indications

2010 ◽  
Vol 2010 ◽  
pp. 1-10 ◽  
Author(s):  
Michail S. Papadopoulos ◽  
Athanasios C. Tolikas ◽  
Dimosthenis E. Miliaras
Keyword(s):  
Vaginal Hysterectomy ◽  
Uterine Artery ◽  
Uterine Prolapse ◽  
Laparoscopic Hysterectomy ◽  
Intraepithelial Neoplasia ◽  
Alternative Methods ◽  
Artery Ligation ◽  
Laparoscopic Procedures ◽  
Uterine Artery Ligation ◽  
Laparoscopic Assisted Vaginal Hysterectomy

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.

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
Keyword(s):  
Uterine Artery ◽  
Laparoscopic Hysterectomy ◽  
Total Laparoscopic Hysterectomy ◽  
Artery Ligation ◽  
Uterine Artery Ligation

scholarly journals Total Laparoscopic Hysterectomy with Prior Uterine Artery Ligation at Its Origin

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Vidyashree Ganesh Poojari ◽  
Vidya Vishwanath Bhat ◽  
Ravishankar Bhat
Keyword(s):  
Blood Loss ◽  
Uterine Artery ◽  
Laparoscopic Hysterectomy ◽  
Total Laparoscopic Hysterectomy ◽  
Artery Ligation ◽  
Uterine Arteries ◽  
Uterine Artery Ligation ◽  
Duration Of Surgery ◽  
Group A ◽  
Group B

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.

scholarly journals Laparoscopic assisted vaginal hysterectomy at the clinic of gynecology and obstetrics in Novi Sad

2019 ◽  
Vol 72 (5-6) ◽  
pp. 143-147
Author(s):  
Srdjan Djurdjevic ◽  
Aleksandra Vejnovic ◽  
Milos Pantelic
Keyword(s):  
Vaginal Hysterectomy ◽  
Uterine Prolapse ◽  
Pelvic Lymphadenectomy ◽  
Artery Ligation ◽  
Gynecology And Obstetrics ◽  
Laparoscopic Assisted Vaginal Hysterectomy ◽  
Clinical Center ◽  
Ureteral Injuries ◽  
Novi Sad ◽  
Laparoscopic Assisted

Introduction. Laparoscopic assisted vaginal hysterectomy is a surgical procedure with uterine artery ligation followed by vaginal removal of the uterus. The first laparoscopic assisted vaginal hysterectomy was performed by Harry Reich in 1989. Material and Methods. The sample included 24 patients who underwent surgery at the Clinic of Gynecology and Obstetrics, Clinical Center of Vojvodina in Novi Sad in the period 2014 - 2017. The most common indications for laparoscopic assisted vaginal hysterectomy included mild uterine prolapse and uterine fibroids (15 patients, 62.5%). The surgery was carried out in two stages: the first, laparoscopic stage and the second, vaginal stage. The laparoscopic stage included mobilization of the bladder, ovaries and uterus to the level of uterine vessels. In the second stage, the cervix was approached vaginally and detached from the urinary bladder, after which the uterus with cervix and adnexa were removed through the vagina. Results. The average age of patients was 56.8 years; on average, the surgeries lasted 140 minutes and the mean blood loss was 190 ml. Two (8.3%) patients experienced bladder and ureteral injuries which were resolved by urologists. Laparoscopic assisted vaginal hysterectomy was the only procedure performed in 5 (20.8%) patients, whereas it was combined with anterior and/or posterior colporrhaphy in 14 (58.4%), with pelvic lymphadenectomy in 3 (12.5%) patients, and with uterine morcellation in 2 (8.3%) patients. Conclusion. There are no published controlled trials related to the use of laparoscopic assisted vaginal hysterectomy and total laparoscopic hysterectomy in Serbia. This paper presents the preliminary results of the laparoscopic assisted vaginal hysterectomy in 24 patients, comparing them with other techniques of hysterectomy conducted at the Clinic of Gynecology and Obstetrics, Clinical Center of Vojvodina in Novi Sad in the period 2014 - 2017. Laparoscopic assisted vaginal hysterectomy is a good option for surgical treatment of patient with combined pathology of genital organs.

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