Identifying the indications for laparoscopically assisted vaginal hysterectomy: a prospective, randomised comparison with abdominal hysterectomy in patients with symptomatic uterine fibroids

Ferrari, María Rosa; Berlanda, Nicola; Mezzopane, R.; Ragusa, G.; Cavallo, Michela; Pardi, Giorgio

doi:10.1111/j.1471-0528.2000.tb13303.x

Cited by 75 publications

(32 citation statements)

References 22 publications

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“…The overall rate of conversion to laparotomy was 21%; the conversion rate significantly decreased with increasing surgeon experience. Ferrari et al [16] reported a 27% rate of conversion to laparotomy in women undergoing LAVH. In six patients in our series, the procedure was converted to laparotomy either because of haemorrhage or difficulty due to extensive adhesions or uterine size.…”

Section: Discussionmentioning

confidence: 99%

A new technique for dissecting the bladder laparoscopically

Bishry

Phillips

2006

Gynecol Surg

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To evaluate a new technique designed to facilitate bladder dissection during laparoscopic-assisted vaginal hysterectomy (LAVH). Minimal access surgery unit, James Cook University Hospital. A retrospective review of 130 LAVHs in which the bladder was dissected laparoscopically. A metal catheter was used to facilitate identification of the bladder edge, and a sponge forceps was inserted vaginally to mark the site for anterior colpotomy. Then monopolar scissors were used to open the vagina. The hysterectomy was then completed vaginally. In this series there were 14 (10.8%) recorded complications with two (1.5%) major complications (95% confidence interval 0.2-5.5%). There was one bladder trauma (0.7%; 95% confidence interval 0.02-4.2%), which was recognised immediately and repaired with laparoscopic intracorporeal knots. One patient required additional vault sutures 6 h postsurgery because of vaginal bleeding. The mean operating time was 98.7 min, and the recorded mean hospital stay was 2.7 days, with a range of 2-5 days. The recorded estimated intraoperative blood loss ranged from 75 to 300 ml, with a mean loss of 195 ml, and four patients required blood transfusion. Dissection of the bladder laparoscopically adds 5-10 min to the operative time but significantly facilitates identifying the appropriate plane. It is an easy technique to learn and teach. It is associated with minimal complications, with no increased incidence of bladder injury or dysfunction.

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Section: Discussionmentioning

confidence: 99%

A new technique for dissecting the bladder laparoscopically

Bishry

Phillips

2006

Gynecol Surg

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“…11,[16][17][18][19] Present study shows that one patient who underwent abdominal hysterectomy had partial gapping and required resuturing. Amirika and Evans in found partial gapping of wound as high as 10.4% and vault infection was 4.6%.…”

Section: Studies By Ottosen Garry Et Al and G Mccracken Et Almentioning

confidence: 99%

Comparative study of abdominal, vaginal and laparoscopic assisted vaginal hysterectomies with special reference to immediate sequel, late sequel and complications

Suraneni

Maharana

2016

Int J Reprod Contracept Obstet Gynecol

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“…Laparoscopic surgery in patients with benign gynaecological diseases has several advantages compared to open surgery such as faster recovery, reduced hospital stay, lower morbidity and better cosmetic results [1][2][3][4]. Although laparoscopic surgery results in improved patient satisfaction, a considerable portion of patients have complaints of post-operative shoulder pain (SP).…”

Section: Introductionmentioning

confidence: 99%

Techniques to reduce shoulder pain after laparoscopic surgery for benign gynaecological disease: a systematic review

2013

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Due to the well-known advantages of minimal invasive surgery, the majority of procedures for benign gynaecological diseases are performed by laparoscopy. Although laparoscopic surgery results in improved patient satisfaction, a considerable portion of patients have complaints of post-operative shoulder pain. This review presents an overview of the currently evaluated techniques to reduce shoulder pain after laparoscopic surgery for benign gynaecological disease. According to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines, a systematic review was conducted using Medline, Embase and Cochrane databases. Randomised clinical trials reporting techniques to reduce shoulder pain after laparoscopic gynaecologic procedures for benign diseases were included. Eighty-eight articles were screened for inclusion. A total of 15 articles were included in the final review. The following studies described the techniques used to reduce shoulder pain: six studies evaluated the effect of local anaesthetics, three studies evaluated the effect of pulmonary recruitment manoeuvre and three studies evaluated the effect of intraperitoneal drainage. The remaining three studies evaluated the effect of saline installation, minilaparoscopy and gasless laparoscopy by using the Laprolift®. Overall, the pulmonary recruitment manoeuvre and intraperitoneal drainage were found to reduce the incidence and severity of shoulder pain (SP). Based on the current evidence, safety and possibility to implement the technique in daily practice, pulmonary recruitment manoeuvre can be recommended to reduce both the incidence and severity of SP.

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Identifying the indications for laparoscopically assisted vaginal hysterectomy: a prospective, randomised comparison with abdominal hysterectomy in patients with symptomatic uterine fibroids

Cited by 75 publications

References 22 publications

A new technique for dissecting the bladder laparoscopically

A new technique for dissecting the bladder laparoscopically

Comparative study of abdominal, vaginal and laparoscopic assisted vaginal hysterectomies with special reference to immediate sequel, late sequel and complications

Techniques to reduce shoulder pain after laparoscopic surgery for benign gynaecological disease: a systematic review

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