Total abdominal hysterectomy versus laparoscopically-assisted vaginal hysterectomy versus total vaginal hysterectomy

Shiota, Mitsuru; Kotani, Yoshihisa; Umemoto, Masahiko; Tobiume, Takako; Shimaoka, Masao; Hoshiai, Hiroshi

doi:10.1111/j.1758-5910.2011.00104.x

Cited by 12 publications

(7 citation statements)

References 20 publications

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“…The retained stump also serves as a plunger to form the apex of vaginal intussusception resulting in vault prolapse. In all cases where there is retained cervix, follow up exfoliative cytology is recommended [13].…”

Section: Introductionmentioning

confidence: 99%

“…However, some still emphasize the advantage of subtotal hysterectomy which include less mortality, reduced vaginal shortening and vault prolapse and increased sexual satisfaction [13]. But the pre-operative cervical smear cytology must be normal and subsequent follow up cervical smear should be guaranteed before subtotal hysterectomy will be advocated.…”

Section: Introductionmentioning

confidence: 99%

“…The vaginal procedure has been shown to be associated with less post-operative pain, less operative blood loss, less risk of trauma to the adjoining viscus, early ambulation, less hospital stay, less cost, and earlier return to normal activities [13]- [15]. Also there is less post-operative morbidity [13]- [15].…”

Section: Introductionmentioning

confidence: 99%

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Indications and Outcome of Gynaecological Hysterectomy at Aminu Kano Teaching Hospital, Kano: A 5-Year Review

Ahmed¹,

Nafi’ah²

2015

OJOG

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Background: Hysterectomy, is a common operation worldwide. It is a major surgery, which leads to significant morbidity and mortality, hence, there must be a justifiable indication before the procedure is undertaken. Symptomatic uterine fibroid and utero-vaginal prolapse are common indications in this environment. Objectives: To determine the prevalence, indications and outcome of hysterectomy at Aminu Kano Teaching Hospital, Kano. Study Design: A retrospective study of all the hysterectomies that were done in Aminu Kano Teaching Hospital, Kano between 1st of Jan 2009 and 31st of Dec 2013. Result: During the period of study, there were 3843 major gynaecological operations. Out of which hysterectomy was 196, giving hysterectomy rate of 5.1% of all major gynaecological operations. Hysterectomy was highest among patient aged 40-49 years accounting for 54.6% of cases and the commonest indication was uterine fibroid, constituting 66.4% of all hysterectomies. Total abdominal hysterectomy was the most frequently preformed, accounting for 78.1% while, vaginal hysterectomy accounts for 20.9% of cases and subtotal hysterectomy was 1%. Hysterectomy was mostly complicated with post-operative pyrexia constituting 24% of all the complications while ureteric injury was the least, constituting 1%. There was no mortality recorded. Most of the patients who had hysterectomy were discharge in less than 10th post-operative day accounting for 91.3% of cases. However, 80.5% of patients who had vagina hysterectomy were discharge in less than 5th post-operative day. Conclusion: The prevalence of hysterectomy was 5.1%. Uterine fibroid was the commonest indication while postoperative pyrexia was the commonest complication found.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Indications and Outcome of Gynaecological Hysterectomy at Aminu Kano Teaching Hospital, Kano: A 5-Year Review

Ahmed¹,

Nafi’ah²

2015

OJOG

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“…These new instrumentations facilitate this minilaparotomy approach to improve the hemostasis and reduce the operation time. As a result, the blood loss reported in this series for the very large fibroids were comparably lower than the open abdominal procedures and equivalent to the laparoscopic procedures reported in the literature [14,16,20]. Therefore instead of using suturing and cut approach as in open abdominal surgery with a large wound, the use of these vessel sealing devices can coagulate and divide vessels and tubes from a distance using the mini-laparotomy wound under a direct vision.…”

Section: Discussionmentioning

confidence: 53%

A Laparoscopic Assisted Minilaparotomy Hysterectomy approach for Very Large Fibroid Uteri of more than 1000 grams – A Preliminary Study

Wong¹

2015

Journal of Gynecology Research

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Objective: To report the surgical outcome of a laparoscopic assisted minilaparotomy hysterectomy (LMH) surgical approach for the management of very large fibroid uteri. [5][6][7][8][9]. However, this minilaparotomy approach might still be considered difficult for the very large fibroid uteri because of the difficulty to assess the sizes and locations of fibroids, presence of adhesions and the iceberg phenomenon of the large fibroid uterus within the pelvis. Introduction A Laparoscopic Assisted Minilaparotomy Hysterectomy approach for Very Large Fibroid Uteri of more than 1000 grams -A PreliminaryOn the other hands, some laparoscopists would also find hysterectomy for very large fibroid uteri difficult to perform. The laparoscopic hysterectomy for large fibroid is known to be difficult surgeries with long operating time, increased blood loss sometimes requiring blood transfusion or conversions to open laparotomy [10][11][12].Setting: A private hospital, St. Paul's Hospital, in Hong Kong Patients and Surgical techniques:It is a retrospective study to assess a hysterectomy approach for very large fibroid uteri of more than 1000 grams. This paper described the surgical technique of this hysterectomy approach and presented the patient characteristics, surgical data and clinical outcome.Result: From 2011 to 2014, 13 women underwent a surgical approach of laparoscopic assisted minilaparotomy hysterectomy with or without salpingo-oophorectomy (LMH +/-SO) for very large fibroid uteri larger than 1000 grams. All hysterectomies were successfully completed without intraoperative or postoperative complication. The amount of blood loss was comparatively less than that of abdominal hysterectomy for very large fibroid uteri reported in the literature. All patients recovered well after operation and many had an early discharge from hospital. Conclusion:In conclusion, this surgical approach for hysterectomy can replace open abdominal hysterectomy for very large fibroid uteri more than 1000 grams. The technique is a combination of laparoscopy and minilaparotomy hysterectomy. It is a safe and feasible alternative as a minimally invasive surgery for very large fibroid uteri.

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“…The appropriate method for holding a needle with forceps is a basic but important technique in laparoscopic surgery. In gynecologic laparoscopic surgery, this technique is used when suturing the vaginal stump and uterine muscles (13)(14)(15)(16). However, needle placement is sometimes inappropriate due to hold angles, as the operational field is 2-D. To correct this, we investigated introducing AR to view the operational images.…”

Section: Introductionmentioning

confidence: 99%

Exploration of assistive technology for uniform laparoscopic surgery

Sato

Koizumi

Hino

et al. 2018

Asian J Endoscop Surgery

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Total abdominal hysterectomy versus laparoscopically-assisted vaginal hysterectomy versus total vaginal hysterectomy

Abstract: LAVH can be applied to nulligravidas or patients with relatively large uteri and it is proved less invasive than TAH and TVH in this study. We recommend active application of LAVH.

Cited by 12 publications

References 20 publications

Indications and Outcome of Gynaecological Hysterectomy at Aminu Kano Teaching Hospital, Kano: A 5-Year Review

Indications and Outcome of Gynaecological Hysterectomy at Aminu Kano Teaching Hospital, Kano: A 5-Year Review

A Laparoscopic Assisted Minilaparotomy Hysterectomy approach for Very Large Fibroid Uteri of more than 1000 grams – A Preliminary Study

Exploration of assistive technology for uniform laparoscopic surgery

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