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Comparison of two procedures for laparoscopic-assisted vaginal hysterectomy of large myomatous uteri

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Comparison of two procedures for

laparoscopic-assisted vaginal hysterectomy of

large myomatous uteri

劉偉民

Yen YK;Liu WM;Yuan CC;Ng HT

摘要

Abstract

Since most abdominal hysterectomies are performed for treatment of large uterine fibroids, an effective laparoscopic approach must be discovered for the endoscopic treatment of large uterine fibroids. We performed a retrospective analysis of all laparoscopic-assisted vaginal hysterectomies (LAVHs) we

performed on uteri that were both greater than 12 weeks' size on preoperative examination and heavier than 450 g on pathologic evaluation. Twenty cases fulfilled the selection criteria, with mean uterine weight of 709 g and operating time of 178 minutes. Two surgical approaches were compared. Group 1 (5 women) consisted of LAVH without supracervical amputation with mean

operating time of 216 minutes. Group 2 (15 women) consisted of laparoscopic supracervical amputation followed by vaginal trachelectomy with mean

operating time of 165 minutes. Our results suggest that laparoscopic

supracervical amputation can enhance the laparoscopic management of large uterine fibroids.

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