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Total Laparoscopic Hysterectomy (TLH) : A Clinical Review of 300 Cases  

Kim, Yeon-Ju (Department of Obstetrics and Gynecology, Boram Hospital)
Ha, Boo-Soo (Department of Obstetrics and Gynecology, Boram Hospital)
Lee, Beum-Deuk (Department of Obstetrics and Gynecology, Boram Hospital)
Lee, Jong-Keun (Department of Obstetrics and Gynecology, Boram Hospital)
Son, Yong-Seuk (Department of Obstetrics and Gynecology, Boram Hospital)
Chugh, Yoon-Won (Department of Obstetrics and Gynecology, Boram Hospital)
Publication Information
Obstetrics & gynecology science / v.45, no.2, 2002 , pp. 292-297 More about this Journal
Abstract
This clinical study was conducted to survey 300 cases of total laparoscopic hysterctomy (TLH) by the Department of Obstetrics and Gynecology of Boram Hospital in Ulsan, Korea from January, 2000 to June, 2001. TLH has been described in much of the recent literature. We analyzed 300 cases of TLH to evaluate the clinical data such as distribution of age, parity, clinical indication, previous operation history, type of surgery, operation time, weight of uterus, Hb change of post-operation first day and the complications of using this technique. The mean age of patients was 41.3. The mean parity of patients was 2.6. The clinical indications for TLH were myoma (72.3%), adenomyosis (11.3%), PID (5.3%), CIS (4%) and others (5.7%). The most previous operation was bilateral tubal ligation. Others were cesarean section, appendectomy. The most concomitant procedure with TLH was posterior colpoperineorrhaphy. Salpingo-oophorectomy and appendectomy were also carried out concomitantly. The mean operation time was 124 minutes. The mean weight of the uterus was 230 gm. The mean Hb change post-operation on the 1st day was 1.3 g/dL. The complications of TLH were bleeding to need blood transfusion, ureteral injury and bladder injury. Thus this technique can be safely performed by skilled laparoscopists for properly selected patients but there is a need for prospective studies for comparision with various laparoscopic hysterctomies.
Keywords
total laparoscopic hysterectomy;
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1 Garry R, Phillips G. How safe is the laparoscopic approach to hysterectomy? Gynecol Endosc 1995; 4: 77.
2 Boike GM, Elfstrand EP, Delpriore G, et al. Laparoscopically assisted vaginal hysterectomy in niversity hospital: Report of 82 cases and comparison with abdominal and vaginal. hysterectomym J Obstet Gynecol 1993; 168: 1690.
3 Chapron C, Dubisson JB, Aubert V, et al. Total laparoscopic hysterectomy; Preliminary results. Human Reprod 1994; 9(11): 2084.
4 Han GS. Assesing the role of laparoscopically assisted vaginal hysterecomy in the everyday practice of gynecology. J Reprod Med 1996; 41: 521.
5 Jones RA. Complications of laparoscopic hysterectomy: 250 cases. Gynecol Endosc 1995; 4: 95.
6 Munro MG, Deprest J. Laparoscopic hysterectomy: Does it work?: a bicontinental review of the literature and clinical commentary. Clin Obstet Gynecol 1995; 38: 401.
7 Nezhat C, Bess D, Admon D, et al. Hospital cost comparison between abdominal, vaginal and laparoscopically assisted vaginal hysterectomies. Obstet Gynecol 1994; 83: 7113.
8 Nezhat C, Gordon SF, Wilkins E, et al. Laparoscopic versus abdominal hysterectomy. J Reprod Med 1992; 37: 274.
9 Reich H, Garry R. Laparoscopic hysterectomy. Oxford: Blackwell publications, 1993; 79.
10 Reich H, McGlynn F. Laparoscopic repair of bladder injury. Obstet Gynecol 1990; 76: 909.
11 Richardson R, Bournas N, Magos AL. Is laparoscopic hysterectomy a waste of time? Lancet 1995; 345: 36.
12 Liu CY, Reich H. Complications of total laparoscopic hysterctomy in 518 cases. Gynecol Endosc 1994; 3: 203.
13 Bornstein SJ, Shaber RE. Laparoscopically assisted vaginal hysterectomy at a health maintenance organization: Cost effectiveness and comparison with total abdominal hysterectomy. J Reprod Med 1995; 40: 435.
14 Hur M, Kim JH, Moon JS, et al. Laparoscopically assisted vaginal hysterectomy. J Reprod Med 1995; 40: 829.
15 curve of the first one hundred laparoscopic hysterectomies. Acta Obstet Gynecol Scand 1995; 74: 638.
16 Hrkki-sirn P, Sjberg J, Mkinen J, et al. Finish national register of laparoscopic hysterectomies: Areview and complications of 1165 operations. Am J Obstet Gynecol 1997; 176: 118.
17 Nezhat CH, Nezbat F, Seidman DS, et al. Vaginal vault evisceration after total laparoscopic hysterectomy. Obstet Gynecol 1996; 87: 868.
18 Chapron C, Dubuisson JB, Ansquer Y, et al. Bladder injuries during total laparoscopic hysterectomy: Diagnosis, management and prevention. J Gynecol Surg 1995; 11: 95.
19 이인국. Laparoscopic hysterectomy. 대한산부내시경회지 1996; 8: 5.
20 Reich H, McGlynn F, Sekel L. Total Laparoscopic hysterectomy. J Gynecol Endos 1993; 2: 59.
21 Chapron C, Dubuisson JB, Aubert V. Laparoscopic hysterectomy: It is not such an expensive surgical procedure. Am J Obstet Gynecol 1994; 170: 1210.
22 Semm K. Tissue puncher and loop ligation: New aids for surgical therapeutic pelviscopy and endoscopic intraabdominal surgery. Endoscopy 1978; 10: 110-9.
23 Summitt RL Jr, Stovall TG, Lipscomb GH, et al. Randomized comparison of laparoscopically assisted vaginal hysterectomy with standard vaginal hysterectomy in an outpatient setting. Obstet Gynecol 1992; 80(6): 895.
24 Chapron C, Dubisson JB. Total laparoscopic hysterectomy for benign uterine pathologies with reusable instruments: A safe, reproducible and cost-effective procedure. Gynecol Endosc 1996; 5: 9.
25 Phipps JH, Tyrrell NJ. Transilluminating ureteric stents for prevention of operative ureteric injury during laparoscopic hysterectomy. Gynecol Endosc 1992; 1(4): 219.
26 Pruitt AB, Stafford RH. Advantages of laparoscopic assisted vaginal hysterectomy. Contemp Obstet Gynecol 1995; 40: 23.
27 Reich H, Decoprio J, McGlynn F. Laparoscopic hysterectomy. J Gynecol Surg 1989; 5: 213.
28 Johns DA, Carrera B, Jones J, et al. The medical and economic impact of laparoscopically assisted vaginal hysterectomy in a large, metropolitan, notforprofit hospital. Am J Obstet Gynecol 1995; 172: 1709.
29 Lee CL, Soong YK. Laparoscopic hysterectomy: Is dissecting the ureter necessary? Int Surg 1995; 80(2): 167.
30 McCartney AJ, Johnson N. Using a vaginal tube to separate the uterus from the vagina during laparoscopic hysterectomy. Obstet Gynecol 1995; 85: 293.