Browse > Article

Simple Total Laparoscopic Hysterectomy: A clinical Evaluation of 312 Cases  

Kim, You-Shin (Department of Obstetrics and Gynecology, College of Medicine, Pocheon CHA University)
Lee, Hong-Seok (Department of Obstetrics and Gynecology, College of Medicine, Pocheon CHA University)
Kwon , So-Young (Department of Obstetrics and Gynecology, College of Medicine, Pocheon CHA University)
Eun, Mi-Na (Department of Obstetrics and Gynecology, College of Medicine, Pocheon CHA University)
Lee, Kyung-Sool (Department of Obstetrics and Gynecology, College of Medicine, Pocheon CHA University)
Park, Young-Sae (Department of Obstetrics and Gynecology, College of Medicine, Pocheon CHA University)
Chung, Chang-Jo (Department of Obstetrics and Gynecology, College of Medicine, Pocheon CHA University)
Kim, In-Hyeun (Department of Obstetrics and Gynecology, College of Medicine, Pocheon CHA University)
Lee, Jeong-Ro (Department of Obstetrics and Gynecology, College of Medicine, Pocheon CHA University)
Publication Information
Obstetrics & gynecology science / v.47, no.1, 2004 , pp. 10-15 More about this Journal
Abstract
Objective : This study was conducted to evaluate the clinical efficacy of simple total laparoscopic hysterectomy in the aspect of operation indication, operation time, hospitalization day, blood loss, and postoperative complications. Methods : A retrospective evaluation for 312 women who undergone simplified total laparoscopic hysterectomy from January, 2002 to June, 2003 was done. Results : The mean age of patients was 45.2 years, mean parity was 2.2, and mean uterine weight was 272.3 gm. The most common surgical indication was uterine myoma in 136 cases (43.5%), followed by adenomyosis in 90 cases (28.8%), myoma combined with adenomyosis in 52 cases (16.6%), uterine prolapse in 15 cases (4.8%), and HSIL 19 cases (6%) respectively. The most common concomitant operation was salpingooophorectomy in 53 cases (16.9%), followed by adhesiolysis in 40 cases (12.8%), colporraphy in 14 cases (4.4%), electrocauterization (ovary) in 4 cases (1.3%), pelvic floor suspension in 4 cases (1.3%), and TVT in 1 case (0.3%). The mean operation time was 107 minutes, and the average hospital day was 5.2 days. The preoperative and postoperative hemoglobin difference was 1.2 gm/dL. The complications of STLH were ureteral injury in 2 cases, intestinal injury in 1 case, and stump bleeding in 1 case. Conclusion : The most important factors for successful STLH were sufficiently trained laparoscopic team and the degree of pelvic adhesion. The most potential advantages of STLH are shorter duration of operation time, hospitalization, and less postoperative complications and more cost effectiveness. Therefore, STLH can be a new alternative option for hysterectomy and may replace the other methods of hysterectomy such as abdominal, vaginal and laparoscopic assisted vaginal hysterectomy (LAVH).
Keywords
Simple total laparoscopic hysterectomy (STLH);
Citations & Related Records
연도 인용수 순위
  • Reference
1 Reich H, Decoprio J, McGlynn F, Laparoscopic hysterectomy. J Gynecol Surg 1989; 5: 213-6
2 Nezhat C, Bess D, Adam D, et al. Hospital cost comparison between abdominal, vaginal and laparoscopically assisted vaginal hysterectomy. Obstet Gynecol 1994; 83: 7113
3 Pruitt AB, Stafford RH. Advantage of laparoscopic assisted vaginal hysterectomy. Contemp Obstet Gynecol 1995; 40: 23
4 Reich H, Decapio J, McGlynn F, Wikie WL, Longo S. Peritoneal trophoblastic tissue implants after laparoscopic treatment of tubal ectopic pregnancy. Fertil Steril 1989; 52: 337-9   PUBMED
5 송준, 이동우, 김동석, 오영미, 정의식, 조정진. 복강경하 전자궁 적출술시 양극성 전기소작기에 의한 자궁동맥처리의 안전성 및 효율성에 관한 연구. 대한산부내시경지 1998: 10(1); 58-63
6 Reich H, McGlynn F, Sekel L. Total laparoscopic hysterectomy. J Gynecol Endos 1993; 2: 59
7 Deprest JA, Munro MG, Koninckx PR. Review on laparoscopic hysterectomy. Zentralbl Gynakol 1995; 117: 641-51   PUBMED
8 Jones RA. Complication of laparoscopic hysterectomy: 250 cases. Gynecol Endosc 1995; 4: 95
9 Jones DA, Carrera B, Jones J, et al. The medical and economic impact of laparoscopically assisted vaginal hysterectomy in large, metropolitan, not for profit hospital. Am J Obstet Gynecol 1995; 172: 1709
10 Keye WR Jr, Laparoscopic treatment of endometriosis. Obstet Gynecol Clin North Am. 1998; 16: 157-66
11 Wattiez, Soiano D, Fiaccavento A, Canis M, Botchorishvili R, Pouly J, et al. Total laparoscopic hysterectomy. J Am Assoc Gynecol Laparosc 2002 May; 9(2): 125-30   DOI   ScienceOn
12 Semm K. Tissue puncher and loop ligation: New aids for surgical therapeutic pelviscopy and endoscopic intraabdominal surgery. Endoscopy 1978; 10: 110-9
13 Hrkki-sirm P, Sjberg J, Mkinen J, et al. Finish national register of laparoscopic hysterectomy: A review and complication of 1165 operation. Am J Obstet Gynecol 1997; 176: 118
14 Bomstein SJ, Shaber RE. Laparoscopically assisted vaginal hysterectomy at a health maintenance organization. Cost-effectiveness and comparision with total abdominal hysterectomy. J Repd Med 1995; 40: 435-8
15 Reich H. Garry R. Laparoscopic hysterectomy. oxford: Blackwell publication 1993; 79
16 Chapron C, Dubussion JB, Aubet V, et al. Total laparoscopic hysterectomy; Preliminary result. Human Repod 1994; 9(11): 2084
17 Nezhat CH, Nezhat C, Admon D, Seidman D, Nezhat F. Complication of 361. laparoscopic hysterectomy. J Am Assoc Gynecol Lapaosc 1994; 1(4, pt 2); S25
18 Munro MG, Depest J. Laparoscopic hysterectomy: Dose it work? A bicontinental review of the literature and clinical commentary. Clin Obstet Gynecol 1995; 38: 401
19 Chapron C, Dubussion JB, Ansquer Y, Fernandez B: J Gynecol Obstet Biol Reprod 1998; 1: 55-61
20 Liu CY, Reich H. Complication of total laparoscopic hysterectomy in 518 cases. Gynecol Endosc 1994; 3: 203
21 Liu CY. Laparoscopic treatment for genuine urinay stress incontinence. Baillieres clin Obstet Gynecol 1994; 8: 789-98   DOI   PUBMED   ScienceOn
22 Phipps JH, Tyrreii NJ. Transilluminating ureteric stent for prevention of operative ureteric injury during laparoscopic hysterectomy. Gynecol Endosc 1992; 1(4): 219
23 Chapron C, Dubussion JB, Aubet V. Laparoscopic hysterectomy: It is not such an expensive procedure. Am J Obstet Gynecolo 1994; 170: 1210