Laparoendoscopic Single-Site Surgery With Hysterectomy in Patients With Prior Cesarean Section: Comparison of Surgical Outcomes With Bladder Dissection Techniques

Safety of total laparoscopic hysterectomy in patients with prior cesarean section

“…The prior CS group was statistically significantly younger than the no CS group. This finding may be a result of rising secular trends in CS rate and is consistent with the results of similar previous studies . In general, age difference could be a limiting factor of the study, considering the possible impact of time on greater exposure to the diseases that could eventually lead to severe adhesions.…”

“…This finding may be a result of rising secular trends in CS rate and is consistent with the results of similar previous studies. 6,14 In general, age difference could be a limiting factor of the study, considering the possible impact of time on greater exposure to the diseases that could eventually lead to severe adhesions. However, incidence of the diseases that led to severe adhesions did not differ significantly between…”

<p>Perioperative Complications of Hysterectomy After a Previous Cesarean Section: A Systematic Review and Meta-Analysis</p>

“…The procedure performed in five included studies was vaginal hysterectomy. 14,17,29,32,33 Ten of the remaining included studies assessed the odds of surgical complications following minimally invasive hysterectomy (laparoscopic-assisted vaginal hysterectomy, total laparoscopic hysterectomy, and roboticassisted hysterectomy) 16,[20][21][22][23]27,28,31,34,35 and 11 included studies assessed the odds of various types of hysterectomy including total abdominal hysterectomy and vaginal hysterectomy. 4,6,15,18,19,[24][25][26]30,36,37 Study designs of the included studies were cohort studies (24) 4,6,14-25,27-29,31-37 and case-control studies (two) 26,30 (Tables S3 and S4).…”

“…Quality assessment among 24 cohort studies using the Newcastle-Ottawa Scale indicated that high risks for comparability and outcome assessment were, respectively, noted in 15 [14][15][16][17][18][21][22][23][24][25]27,28,33,34,36 and 12 studies. 6,14,15,17,18,22,27,29,31,33,34,37 No cohort study was judged as having a high risk of selection bias. The two case-control studies 26,30 included in this review were determined as having low-to-moderate risks of bias for all items.…”

Preoperative assessment of factors associated with difficulty in performing total laparoscopic hysterectomy

“…It has been reported that bleeding volume, operation time, and conversion to open surgery are affected by body mass index (BMI), pelvic adhesion, prior surgery, uterine volume, patient's age, and surgeon's skill . However, although some of these factors (e.g., pelvic adhesion or uterine volume) cannot be preoperatively ascertained, it is important to preoperatively identify difficult patients.…”