| Abstrakt: |
Objective: The aim of this study was to evaluate an original technique of laparoscopic supracervical hysterectomy with endocervical resection (LSH with ER) in the framework of a private practice and a university hospital. This method allows to leave intact the cervical tissue, the corresponding ligaments, and the topography of the ureters. Methods: From May 1998 to November 2004, 122 patients underwent a LSH with ER for benign pathologies. The average age was 49.7 years (range, 33–69). The indications were failure of medical treatment for uterine bleeding, dysmenorrhoea, and enlarged uterus. In this study, we evaluated periand postoperative complications. The surgical procedure included four steps: (1) a conventional laparoscopic procedure until the uterine pedicles section; (2) an endocervical resection by the vaginal route until the uterine cavity, using an electric morcellator; (3) a fast laparoscopic section of the isthmus; and (4) a transcervical removal of the uterus using the morcellator device. Results: The average operating time was 117 minutes (range, 45–210 minutes). Intraoperative blood loss was minimal, with an average of 37 mL (range, 5–550 mL). The uterus weight was 215 g (range, 60–880 g). The hospital stay was 54 hours (range, 20–161 hours). We observed no major complications, no conversion to laparotomy, no blood transfusion, and no reintervention was required. Only 1 case of postoperative occasional spotting during 32 days, and 1 endocervical infection resolved by local treatment, were noted. Since 1998, no complications or sequelae were observed. Conclusions: This original technique by laparoscopic supracervical hysterectomy with endocervical resection is a safe, minimally invasive surgery procedure and is feasible in a private practice and in a university hospital, with few complications and without any postoperative bleeding. It offers cosmetic, small abdominal incisions, and, most of all, respects the pelvic floor support. (J GYNECOL SURG 21:155) [ABSTRACT FROM AUTHOR] |
