Abstract
Objective: To compare peroperative parameters of two variants of a laparovaginal hysterectomy
in surgical management of gynecological conditions. Methods: A prospective randomized study of 70 laparovaginal hysterectomies performed by the
same two surgeons for disease of female pelvic organs. The following criteria were
studied: indication for surgery, previous surgery, duration of the procedure, recovery,
hospital stay, blood loss, tissue damage markers, hysterectomy proportions and complication
incidence. Statistical analysis was performed using the non-parametric χ2-test and non-parametric Fischer’s exact probability test when appropriate, with a
level of significance P=0.05. Results: Totals of 38 (54.3%) laparoscopy-assisted vaginal and 31 (45.7%) vaginally assisted
laparoscopic hysterectomies were performed for fibroma as the main indication. Conversion
to laparotomy was applied in only one patient. The VALH group (P=0.01) showed both fewer procedures and shorter hospital stay with insignificant blood
loss. Conclusion: The two variants of a laparovaginal hysterectomy appear to be safe and appropriate,
effective procedures for women with gynecological conditions. Furthermore, vaginally
assisted laparoscopic hysterectomy has been shown to be superior to laparoscopy-assisted
vaginal hysterectomy in terms of shorter operating time and greater palliative effect
upon the complex of uterosacral ligaments. Laparoscopic surgery can alter the relationship
between vaginal and abdominal hysterectomy.
Keywords
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References
- Laparoscopic Hysterectomy. 1st ed. Galén, Prague1999
- Hysterectomy: a critical review.J. Reprod. Med. 1990; 35: 839-862
- Proposed classification of hysterectomies involving hysterectomy.J. Am. Assoc. Gynecol. Laparosc. 1995; 2: 427-429
- A randomised prospective study of laparoscopic vaginal hysterectomy versus abdominal hysterectomy each with bilateral salpingo-oophorectomy.Br. J. Obstet. Gynaecol. 1994; 101: 1067-1071
- Can laparoscopic assisted hysterectomy safely replace abdominal hysterectomy.Br. J. Obstet. Gynaecol. 1993; 100: 932-934
- Initial experience laparoscopic-assisted Doderlain hysterectomy.Br. J. Obstet. Gynaecol. 1995; 102: 307-310
- Laparoscopically assisted vaginal hysterectomy: report of 190 cases.J. Laparoendosc. Adv. Surg. Tech. A. 1997; 7: 13-18
- A new technique and systém for simplifying total laparoscopic hysterectomy.J. Am. Assoc. Gynecol. Laparosc. 1998; 5: 187-192
- Laparoscopic hysterectomy.J. Gynecol. Surg. 1989; 5: 213-216
- Assessing the role of laparoscopically assisted vaginal hysterectomy in the every day practice of gynecology.J. Reprod. Med. 1996; 41: 521-528
- Indication of laparoscopic hysterectomy.Eur. J. Obstet. Gynecol. Reprod. Biol. 1997; 74: 49-52
- Laparoscopic, abdominal and vaginal hysterectomy: a comparative study.Saudi Med. J. 1998; 19: 731-734
- Hysterectomy with adnexectomy. Can operative laparoscopy offer advantages?.J. Reprod. Med. 1997; 42: 201-206
- Total hysterectomy by laparoscopy: advantage for the patient or only surgical gimmick?.J. Gynecol. Surg. 1995; 12: 75-88
- Poor vaginal access: excellent indication for laparoscopic hysterectomy.J. Gynecol. Obstet. Biol. Reprod. Paris. 1997; 26: 789-797
- Endometriosis among women with uterine myomata: prevalence and outcomes in a series of 256 laparoscopic hysterectomies.Obstet Gynecol Suppl. 1999; 93: 85
- Is laparoscopic a waste of time?.Lancet. 1995; 345: 36-41
- Guidelines to determine the route of hysterectomy.Obstet. Gynecol. 1995; 85: 18-23
- Laparoscopic vaginal hysterectomy versus abdominal hysterectomy (Letter).Br. J. Obstet. Gynecol. 1995; 102: 511-512
- Surgical trauma and metabolic changes induced by surgical laparoscopy versus laparotomy.Gynaecol. Endosc. 1997; 6: 1-6
- Assessment of tissue damage during laparoscopic and conventional hysterectomy.Gynaecol. Endosc. 1998; 7: 243-249
- Review on laparoscopic hysterectomy.Zbl. Gynäkol. 1995; 117: 641-651
- Complications of total laparoscopic hysterectomy in 518 cases.Gynaecol. Endosc. 1994; 3: 203-208
- The perioperative bleeding in relation to laparoscopic hysterectomy: a retrospective study.Czech Gynaecol. 1999; 64: 143-146
- Complications and results of 361 hysterectomies performed at laparoscopy.J. Am. Coll. Surg. 1995; 180: 307-316
- Vaginally assisted laparoscopic hysterectomy a technique suited for large uteri.Gynaecol. Endosc. 1997; 6: 95-957
- Minimalisation of traditional hysterectomy techniques by CISH, IVH and TUMA using CURT.Int. J. Gynecol. Obstet. 1994; 46: 16
Article info
Publication history
Accepted:
August 19,
1999
Received in revised form:
June 17,
1999
Received:
March 12,
1999
Identification
Copyright
© 2000 Elsevier Science Ireland Ltd. Published by Elsevier Inc. All rights reserved.
