scholarly journals Non-descent Vaginal Hysterectomy: Safety and Feasibility

2014 ◽  
Vol 7 (2) ◽  
pp. 14-16
Author(s):  
R Saha ◽  
NS Shrestha ◽  
M Thapa ◽  
J Shrestha ◽  
J Bajracharya ◽  
...  
Keyword(s):  
Blood Loss ◽  
Hospital Stay ◽  
Vaginal Hysterectomy ◽  
College Teaching ◽  
Successful Outcome ◽  
Transverse Diameter ◽  
Medical College ◽  
Estimated Blood Loss ◽  
Duration Of Surgery ◽  
Adnexal Pathology

Aims: To assess safety and feasibility of non-descent vaginal hysterectomy. Methods: A hospital based prospective study was conducted at the department of obstetrics and gynecology of Kathmandu Medical College Teaching Hospital from 1st January 2010 to 31st December 2011. All the patients undergoing non -descent vaginal hysterectomy for benign indication, without suspected adnexal pathology were included in the study. Vaginal hysterectomy was done in usual manner. In bigger size uterus morcellation techniques like bisection, debulking, myomectomy, slicing, or combination of these were used to remove the uterus. Data regarding age, parity, uterine size ,estimated blood loss, length of operation, complication and hospital stay were recorded. Results: A total of 50 cases were selected for non-descent vaginal hysterectomy. Among them 43 cases successfully underwent non-descent vaginal hysterectomy. Commonest age group was (41-45 years) i.e. 40%. All patients were parous. Uterus size was <10 weeks in 27 cases and >10 weeks in 23 cases. Commonest indication was leiomyoma of uterus (63%). Mean duration of surgery was two hours. Mean blood loss was 205.26ml. Reasons for failure to perform NDVH was difficulty in opening pouch of Douglas in three cases. In rest of four cases there was difficulty in reaching the myoma and transverse diameter was too large so as to prevent descent of the uterus. The most common complication was post –operative pain in 23% of cases. Febrile morbidity was present in 4.6% of cases. Blood transfusion was required in seven cases. Average duration of hospital stay was three days. Conclusions: Vaginal hysterectomy for benign gynecological causes other than prolapse is safe and feasible. For successful outcome size of uterus, size in all dimensions and location of fibroid should be taken into consideration.Today in the era of minimally invasive surgery, non descent vaginal hysterectomy needs to be considered and seems to be a safe option. DOI: http://www.dx.doi.org/10.3126/njog.v7i2.11134   Nepal Journal of Obstetrics and Gynaecology / Vol 7 / No. 2 / Issue 14 / July-Dec, 2012 / 14-16

scholarly journals Non Descent Vaginal Hysterectomy: A Rational Surgical Approach

KYAMC Journal ◽  
2017 ◽  
Vol 6 (2) ◽  
pp. 637-641
Author(s):  
Arifa Akter Zahan ◽  
Kh Shahnewaz ◽  
Ummay Salma
Keyword(s):  
Blood Loss ◽  
Hospital Stay ◽  
Vaginal Hysterectomy ◽  
Average Duration ◽  
Uterine Prolapse ◽  
Rational Approach ◽  
Medical College ◽  
Gynecological Disorders ◽  
Estimated Blood Loss ◽  
Duration Of Surgery

Aims: To evaluate the rational approach of non-descent vaginal hysterectomy in advancing gynaecology practice.Study Design: Retrospective study and period from 1st July 2013 to 31st June 2014. Setting Kumudini Women's Medical College & Hospital, Mirzapur, Tangail.Patients: All selective patients requiring hysterectomy for benign gynecological disorders who did not have any uterine prolapse were recruited for this study. In bigger size uterus morcellation techniques like bisection, debulking, myomectomy, slicing, or combination of these were used to remove the uterus.Main outcome measures: Data regarding indication, age, parity, uterine size, estimated blood loss, length of operation, complication and hospital stay were recorded.Results: A total of 50 cases were selected for non-descent vaginal hysterectomy all of them successfully underwent non-descent vaginal hysterectomy. Commonest age group was (41-45 years) i.e. 46%. All patients were parous. Uterus size was less then 8 wks 21 cases, 8wks to 12 wks in 27 cases, more then 12 wks 02 cases. Commonest indication was DUB of uterus (44%). Mean duration of surgery was 50.5 minutes. Mean blood loss was 100ml. Blood transfusion was required in four cases. Average duration of hospital stay was 3.1 days. Complications were minimal which included UTI and Vault infection.Conclusions: NDVH is safe feasible and patient friendly. We suggest that our modern gynecologist will be more expertise and familiar to this procedure in near future.KYAMC Journal Vol. 6, No.-2, Jan 2016, Page 637-641

scholarly journals Non-descent vaginal hysterectomy for large uterus-safety and feasibility

2018 ◽  
Vol 7 (9) ◽  
pp. 3563
Author(s):  
Rameshkumar R. ◽  
Sahana N. Naik ◽  
Dhanalakshmi .
Keyword(s):  
Blood Loss ◽  
Hospital Stay ◽  
Vaginal Hysterectomy ◽  
Cost Effective ◽  
Cost Effective Method ◽  
Duration Of Surgery ◽  
Operative Complications ◽  
Large Uterus ◽  
Duration Of Operation ◽  
Post Operative Complications

Background: Non Descent Vaginal Hysterectomy (NDVH) is removal of uterus through vagina in non-prolapsed uterus. The objective of the present study was to assess safety and feasibility of NDVH in patients with large uterus (>12 weeks size uterus).Methods: Retrospective study was conducted in Department of Obstetrics and Gynecology of Shree Dharmasthala Manjunatheshwara (SDM) College of Medical Sciences and Hospital, Dharwad, India from May2014 to May 2017. Effort was made to perform hysterectomies vaginally in women with benign conditions with large uterine size. Information regarding age, parity, uterine size, blood loss, duration of operation, number of fibroids, other surgical difficulties encountered, intra–operative and post-operative complications were recorded.Results: Total of 65 cases was selected for NDVH with large uterine size. All successfully underwent NDVH. 25 patients had uterus of 10-12 weeks size, 17 had uterine size of 12-14 weeks size. Mean duration of surgery was 90 min. Mean blood loss was 300ml. Post-operative complications were minimal. All patients had early mobility with faster resumption to daily activities. Mean hospital stay was 4-5 days.Conclusions: Non descent vaginal hysterectomy is safe, cost effective method of hysterectomy in women with large uterus requiring hysterectomy for benign conditions with less complications, shorter hospital stay and less morbidity.

scholarly journals A pilot study evaluating the feasibility of non-descent vaginal hysterectomy for benign gynecological indications in women in rural India

2017 ◽  
Vol 6 (10) ◽  
pp. 4424
Author(s):  
Anjali Soni ◽  
Pawan Kumar Soni ◽  
Chanderdeep Sharma ◽  
Suresh Verma ◽  
Shivani Vashasit
Keyword(s):  
Pelvic Organ Prolapse ◽  
Pilot Study ◽  
Blood Loss ◽  
Hospital Stay ◽  
Vaginal Hysterectomy ◽  
Vaginal Surgery ◽  
Pelvic Organ ◽  
Rural India ◽  
Duration Of Surgery ◽  
Abdominal Route

Background: Hysterectomy for benign indications is one of the common surgical procedures performed on women worldwide. Despite the available evidence favouring vaginal surgery still abdominal route is preferred in majority of women in rural India. Hence, this pilot study was done to determine the feasibility of Non-descent vaginal hysterectomy (NDVH) in rural India.Methods: All women planned for hysterectomy for benign indications (with no or minimal pelvic organ prolapse) during a period of six months were enrolled after taking informed consent and subsequently, underwent NDVH. Data was analyzed retrospectively with respect to duration of surgery, average blood loss, complications of surgery and duration of stay in the hospital.Results: All except one woman out of 37 women enrolled for the study had an un-eventful surgery with median duration of surgery [median 30 minutes; (range 30-55 minutes)], median hospital stay [(median 2 days) range 2-7 days], and minimal blood loss [median 50 ml (range 50-200 ml)]. There was one case of inadvertent cystotomy (diagnosed and repaired intra-operatively), and discharged in healthy condition on seventh post-operative day.Conclusions: NDVH is a safe option for hysterectomy (in women without pelvic organ prolapse) for benign indications even in rural India. It has been found to be associated with short hospital stay, minimal blood loss and short recovery time.

scholarly journals Non Descent Vaginal Hysterectomy: A Rational Surgical Approach

2016 ◽  
Vol 30 (1) ◽  
pp. 15-19
Author(s):  
Arifa Akter Zahan ◽  
Kh Shahnewaz ◽  
Fahmida Khan ◽  
Ummay Salma
Keyword(s):  
Blood Loss ◽  
Vaginal Hysterectomy ◽  
Prospective Observational Study ◽  
Average Duration ◽  
Target Population ◽  
Bladder Injury ◽  
Medical College ◽  
Obstetrics And Gynaecology ◽  
Duration Of Surgery ◽  
Abdominal Route

Objective(s): The aim of the study wasto evaluate the safety and feasibility of non-descent vaginal hysterectomy in advancing gynaecological practice.Materials and methods: This prospective observational study was conducted from 1st July 2013 to 31st June 2014 in Obstetrics and Gynaecology Department of Kumudini Women’s Medical College & Hospital, Mirzapur, Tangail. Fifty patients who needed hysterectomy for benign gynaecological disorders and who had no descent of uterus or vagina were the target population for this study. Main outcome measures were i) difficulty of operation, ii) procedures for overcoming the difficulties,iii) switch over to abdominal route, iv) time taken to complete the operation, v) blood loss during operation vi) need of blood transfusion and vii) postsurgical hospital stay.Results: In all (100%) cases vaginal hysterectomy was completed successfully. Commonest age group (46%) was between 41-45 years. All patients were parous. Size of the uterus was less then 8 wks in 21 cases, 8wks to 12 wks in 27 cases and more than 12 wks in 02 cases. Commonest indication was dysfunctional uterine bleeding (DUB) (44%). Mean duration of surgery was 50.5 ± 5.46 minutes. Mean blood loss was 100± 22.43 ml.Blood transfusion was required in four cases. Average duration of hospital stay was 3.1± 1.2 days. Complications were minimum which included, bladder injury, UTI and Vault infection.Conclusions: In properly selected cases non-descent vaginal hysterectomy is safe, feasible and patient friendly.Bangladesh J Obstet Gynaecol, 2015; Vol. 30(1) : 15-19

scholarly journals Study on safety of non-descent vaginal hysterectomy for enlarged uterine size for benign uterine pathologies

2019 ◽  
Vol 8 (4) ◽  
pp. 1588
Author(s):  
Neelam Manda ◽  
Oby Nagar ◽  
Lata Rajoria ◽  
C. P. Dadhich
Keyword(s):  
Blood Loss ◽  
Vaginal Hysterectomy ◽  
Demographic Data ◽  
Pelvic Sepsis ◽  
Control Group ◽  
Complication Rates ◽  
Index Group ◽  
Estimated Blood Loss ◽  
Duration Of Surgery ◽  
The Mean

Background: Vaginal hysterectomy is less commonly performed for benign pathologies if the uterine size exceeds 12 weeks in the belief that complications could be higher in this group. The aim of this prospective study was to compare surgical outcomes and safety of vaginal hysterectomy in women with non-prolapsed uteri of >12 weeks size to those with uteri of<12 weeks removed vaginally for similar indications.Methods: In this prospective cohort study, 92 patients were included who underwent NDVH for benign uterine conditions between May 2016 to December 2018. The index group comprised 32 women who underwent vaginal hysterectomy for non-prolapse uterus with uterine enlargement (>12 weeks), while the control group consisted of 60 women with uteri <12 weeks. Demographic data, duration of surgery, blood loss, intraoperative and postoperative complications were compared.Results: Women in the two groups had statistically similar mean age, Body Mass Index and parity (44 vs 42.77 years, 20.8 vs 21.56 kg m3 and 3.26 vs 3.83, respectively; p > 0.05). The mean operative time was significantly longer in the index group (62.47min; vs 48.17 min; p <0.0001). Women with enlarged uteri had greater mean estimated blood loss (123.2 ml vs 75.9 ml; p < 0.0001) but the mean length of hospital stay was similar (5.531 days vs 5.177 days; p > 0.05). Intra- and post-operative complications such as blood transfusion and pelvic sepsis, post-operative febrile illness and systemic infections were comparable in both groups.Conclusions: Vaginal hysterectomy in larger non-prolapsed uteri takes longer to perform and is associated with more blood loss compared to uteri <12 weeks but is not associated with a significant increase in complication rates.

scholarly journals Comparison of morbidity associated with non-descent vaginal hysterectomy and total abdominal hysterectomy

2018 ◽  
Vol 7 (4) ◽  
pp. 1554
Author(s):  
Ranjita Ghadei ◽  
Gupteswar Mishra
Keyword(s):  
Blood Loss ◽  
Hospital Stay ◽  
Vaginal Hysterectomy ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Intraoperative Blood Loss ◽  
Duration Of Hospital Stay ◽  
Duration Of Surgery ◽  
Stay Time ◽  
Normal Work

Background: In the present scenario of importance non-invasive surgery, there is increase in interest and requirement of vaginal hysterectomy for non-prolapsed uterus, i.e. non-descent vaginal hysterectomy (NDVH) due to its scarless surgery. it has much more advantages than that of abdominal hysterectomy in term of cosmesis, lesser duration of surgery, lesser intraoperative complication, lesser post-operative morbidity and early resumption to work. The aim of the present study is to asses and compare various factors like duration of surgery, intraoperative blood loss, intraoperative and postoperative complication postoperative morbidities, pain perception on 3rd post-operative day, post-operative ambulation, duration of hospital stay, time taken to resume normal work, follow up complains and afterall to decide the appropriate route of hysterectomy for benign conditions.Methods: Hundreds of patients were selected as per the criteria. They were divided into two groups NDVH (non-descent vaginal hysterectomy) and TAH (total abdominal hysterectomy) according to the inclusion criteria. Above mentioned factors are compared between the two groups.Results: Duration of surgery, intraoperative blood loss, intraoperative complications, post-operative morbidities and complications, duration of hospital stay, time required to resume normal work are less in NDVH group.Conclusions: Non-descent vaginal hysterectomy is a better alternative to abdominal hysterectomy for benign conditions.

scholarly journals Comparative Study between Laparoscopic Assisted and Traditional Vaginal Hysterectomy

2019 ◽  
Vol 13 (2) ◽  
pp. 29-31
Author(s):  
Liza Chowdhury
Keyword(s):  
Blood Loss ◽  
Comparative Study ◽  
Hospital Stay ◽  
Vaginal Hysterectomy ◽  
Armed Forces ◽  
Laparoscopic Assisted Vaginal Hysterectomy ◽  
Post Operative Pain ◽  
Estimated Blood Loss ◽  
Significant Difference ◽  
Laparoscopic Assisted

Introduction: The choice of hysterectomy approach depends on the reason for hysterectomy, the overall health of the patient and surgeon’s experience. The choice of technique dictates hospital stay and healing time. Objective: To compare the efficacy and outcome of Laparoscopic Assisted Vaginal Hysterectomy (LAVH) and traditional Vaginal Hysterectomy (VH). Materials and Method: A total of 100 patients were purposively selected for this prospective comparative study during the period of January 2011 to January 2013 in CMH, Dhaka and Hitech Multicare Hospital. Non-malignant patients undergoing LAVH and VH by the same surgeon were included in this study. Clinical variables such as operative time, operative cost, blood loss, quantity of analgesics used and hospital stay were observed in both cases for comparison. Several other variables were also observed as postoperative complications such as amount of haemoglobin decrease, rise of temperature, urinary tract infection, vault granuloma in both the cases. Results:  There was no significant difference in terms of age, parity, body weight, uterine weight. The mean estimated blood loss in VH (100±32.8 ml) was significantly lower compared to LAVH (126.5±39.8 ml) group. Comparing the relief of post-operative pain, less analgesic was required, rapid patient recovery, and hospital stay time was less in LAVH group than VH group. Conclusion: LAVH is clinically beneficial in terms of less post-operative pain and less quantity of analgesia used, rapid patients’ recovery and shorter hospital stay than VH. It is useful for patients who prefer laparoscopy for cosmetic purpose. Journal of Armed Forces Medical College Bangladesh Vol.13(2) 2017: 29-31

scholarly journals Feasibility of bilateral salpingo-oophorectomy during vaginal hystertectomy for benign uterine diseases

2019 ◽  
Vol 8 (5) ◽  
pp. 1757
Author(s):  
Kavitha G. ◽  
Anitha D.
Keyword(s):  
Vaginal Hysterectomy ◽  
Menopausal Status ◽  
Postoperative Recovery ◽  
Uterine Disease ◽  
Medical College ◽  
Duration Of Surgery ◽  
Adnexal Pathology ◽  
Almost All ◽  
Uterine Diseases ◽  
Ovarian Syndrome

Background: Prophylactic bilateral salpingo-oophorectomy (BSO) remains the best measure in the prevention of ovarian cancer as it lacks an effective screening tool. The need to perform prophylactic BSO shouldn't dictate the route of surgery. To assess the feasibility of prophylactic BSO during vaginal hysterectomy. To analyze the safety of the vaginal BSO.Methods: This was a retrospective study conducted in the Department of Obstetrics and Gynaecology at Velammal Medical College, Madurai, Tamilnadu, India from June 2016 to June 2018 over a period of 3 years. 54 women who underwent hysterectomy for benign uterine disease in whom concomitant prophylactic BSO was attempted were included in the study. Preoperative data like age, parity, menopausal status, BMI, previous pelvic surgeries were noted from the admission record. Intraoperative details like indication for surgery, surgical procedure, duration of surgery and complications like hemorrhage, bladder, ureter and bowel injury were collected from the operative record. Postoperative recovery details were also noted down from the case sheet. The collected data were then analyzed.Results: Of the 54 women included in the study, transvaginal BSO was successful in 53 (98.1%) women. There was one case of primary haemorrhage due to slippage of ovarian pedicle, another patient required laparotomy for completing BSO. None had bladder, ureter or bowel injury.Conclusions: Prophylactic BSO is both feasible and safe in almost all patients undergoing vaginal hysterectomy. Developing the skill to perform transvaginal BSO can inspire gynaecologists to move a step forward and deal with benign adnexal pathology concomitantly at vaginal hysterectomy. The risk of remnant ovarian syndrome post vaginal oophorectomy is unknown.

scholarly journals Robotically Assisted Hysterectomy versus Vaginal Hysterectomy for Benign Disease: A Prospective Study

2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
M. Carbonnel ◽  
H. Abbou ◽  
H. T. N’Guyen ◽  
S. Roy ◽  
G. Hamdi ◽  
...  
Keyword(s):  
Blood Loss ◽  
Prospective Study ◽  
Hospital Stay ◽  
Vaginal Hysterectomy ◽  
Operative Time ◽  
Group Versus ◽  
Length Of Hospital Stay ◽  
Benign Disease ◽  
Post Surgery ◽  
A Prospective Study

Objectives. A prospective study was carried out to compare vaginal hysterectomy (VH) and robotically assisted hysterectomy (RH) for benign gynecological disease.Materials and Methods. All patients who underwent hysterectomy from March 2010 to March 2012 for a benign disease were included. Patients’ demographics per and post surgery results were collected from medical files. A questionnaire was also conducted 2 months after surgery.Results. Sixty patients were included in the RH group and thirty four in the VH one. Operative time was significantly longer in the RH group ( versus  min; ). Blood loss and length of hospital stay were significantly reduced: versus  ml; , and versus days; , respectively. Less pain was reported at D1 and D2 by RH patients, and levels of analgesia were lower compared to those observed in the VH group. No differences were found regarding the rate of conversion to laparotomy, intra- or postoperative complications.Conclusion. Robotically assisted hysterectomy appears to reduce blood loss, postoperative pain, and length of hospital stay, but it is associated with longer operative time and higher cost. Specific indications for RH remain to be defined.

scholarly journals One hundred consecutive endoscopic repairs of sagittal craniosynostosis: an evolution in care

2017 ◽  
Vol 20 (5) ◽  
pp. 410-418 ◽  
Author(s):  
Dennis C. Nguyen ◽  
Scott J. Farber ◽  
Gary B. Skolnick ◽  
Sybill D. Naidoo ◽  
Matthew D. Smyth ◽  
...  
Keyword(s):  
Blood Loss ◽  
Patient Care ◽  
Length Of Hospital Stay ◽  
Successful Outcome ◽  
Emissary Vein ◽  
Sagittal Craniosynostosis ◽  
Care Protocol ◽  
Estimated Blood Loss ◽  
Helmet Therapy ◽  
The Mean

OBJECTIVEEndoscope-assisted repair of sagittal craniosynostosis was adopted at St. Louis Children’s Hospital in 2006. This study examines the first 100 cases and reviews the outcomes and evolution of patient care protocols at our institution.METHODSThe authors performed a retrospective chart review of the first 100 consecutive endoscopic repairs of sagittal craniosynostosis between 2006 and 2014. The data associated with length of hospital stay, blood loss, transfusion rates, operative times, cephalic indices (CIs), complications, and cranial remolding orthosis were reviewed. Measurements were taken from available preoperative and 1-year postoperative 3D reconstructed CT scans.RESULTSThe patients’ mean age at surgery was 3.3 ± 1.1 months. Of the 100 patients, 30 were female and 70 were male. The following perioperative data were noted. The mean operative time (± SD) was 77.1 ± 22.2 minutes, the mean estimated blood loss was 34.0 ± 34.8 ml, and the mean length of stay was 1.1 ± 0.4 days; 9% of patients required transfusions; and the mean pre- and postoperative CI values were 69.1 ± 3.8 and 77.7 ± 4.2, respectively. Conversion to open technique was required in 1 case due to presence of a large emissary vein that was difficult to control endoscopically. The mean duration of helmet therapy was 8.0 ± 2.9 months. Parietal osteotomies were eventually excluded from the procedure.CONCLUSIONSThe clinical outcomes and improvements in CI seen in our population are similar to those seen at other high-volume centers. Since the inception of endoscope-assisted repair at our institution, the patient care protocol has undergone several significant changes. We have been able to remove less cranium using our “narrow-vertex” suturectomy technique without affecting patient safety or outcome. Patient compliance with helmet therapy and collaborative care with the orthotists remain the most essential aspects of a successful outcome.

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