Total laparoscopic hysterectomy with suture technique

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Abstract
Objective: To evaluate the efficacy of total laparoscopic hysterectomy (TLH) with suture technique.Design: Review of hospital records of 108 women who underwent total laparoscopic hysterectomy between January 1 1994 and December 31 1996.Setting: Department of obstetrics and gynaecology at a university teaching hospital.Subjects: 108 women who underwent total laparoscopic hysterectomy.Interventions: All the hysterectomy procedures were performed in the classic manner, with scissors, grasping forceps, bipolar coagulation and suture technique as in total abdominal hysterectomy (TAH).Main outcome measures and results: Indications, patient characteristics, associated procedures, surgical outcomes, and complications were analysed. The mean age of the patients was 44.7 ± 5.0 years. The most common surgical indication was squamous intraepithelial lesion of the cervix, including carcinoma in situ and dysplasia. The mean operating time was 173.4 ± 80.4 min, and blood loss (189 ± 105 ml) was lower than that of conventional abdominal hysterectomy. Mean uterine weight was 87.3 ± 24.3 g. None of the procedures was converted to laparotomy. There were no intraoperative complications, and a few postoperative complications were noted, specifically three out of 108 cases, comprising 2.8%. The complications included two vaginal vault infections and a febrile condition.Conclusions: Our findings suggest that total laparoscopic hysterectomy with a suture technique is feasible, cost‐effective, safer than, and a good alternative to, abdominal and vaginal hysterectomy.

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