scholarly journals Lift-Assisted Laparoscopy in Hysterectomy: A Retrospective Study of 32 Consecutive Cases

2013 ◽  
Vol 2013 ◽  
pp. 1-4
Author(s):  
Bo S. Bergström

A large uterus is the most commonly reported obstacle to laparoscopic hysterectomy. It reduces the intra-abdominal free space, limits visualization and instrumentation, causes technical difficulties, and increases the potential for complications. The logical solution to this dilemma is to address the underlying problem and increase the intra-abdominal free space. This can be done readily by supplementing the conventional pneumoperitoneum by concurrent mechanical lifting of the abdominal wall using the camera trocar as an anchoring device. Such lift-assisted laparoscopy augments the intra-abdominal free space formation, and lifts the laparoscope to a higher position to give a panoramic view, even when the uterus is large. This retrospective study of 32 consecutive cases of laparoscopic hysterectomy indicates that the use of lift-assisted laparoscopy is safe for the patient and that a large uterus is not a contraindication. The operations were long, but complications were few. Lift-assisted laparoscopy is an option to improve patient care by modifying surgical procedures. Operating time, per se, is not a valid measure of quality in laparoscopic hysterectomy. The more traumatic abdominal hysterectomy procedures need not be selected in preference over lengthy minimally invasive techniques. Other techniques, such as solo surgery and in-office surgery, are also discussed.

Author(s):  
Suma S. Moni ◽  
Suchith Hoblidar ◽  
Rathnamala M. Desai ◽  
Sunil Kumar K. S.

Background: Hysterectomy is one of the most common gynecological surgeries performed around the world. This study was done to review the data of all patients who underwent TLH. With this study a uniform method of performing TLH by a single surgeon was assessed.Methods: A 5 years retrospective study was performed at Sri Dharmasthala Manjunatheshwara College of Medical Sciences and Hospital Dharwad, Karnataka India. Demographic data, pre-operative findings, indication for surgery, intra-operative and post-operative complications, duration of surgery were recorded and analyzed.Results: A total of 118 women were included in the study. Mean age of the patients wasMost common indication for the surgery was leiomyoma. Mean operating time was 162.18 minutes. Mean weight of the post-operative specimen was 208.45 grams. Intra-operative urinary bladder injury was seen in 1 patient. Conversion to laparotomy was needed in 2 patients.Conclusions: With improving experience TLH can be performed safely without complications. As number of surgeries done increases duration of TLH reduces. TLH can be effectively used to avoid laparotomy.


2020 ◽  
pp. 1-2
Author(s):  
Suchandra Suchandra ◽  
Renu Jha ◽  
Kumudini Jha ◽  
Debarshi Jana

Background: Hysterectomy is the most common operation performed by gynecologist, next to caesarean section. Currently, there are three main types of hysterectomy operations in practice for benign diseases-Abdominal hysterectomy (AH), vaginal hysterectomy (VH) and Laparoscopic hysterectomy (LH). Vaginal route for non-descentuterus is an acceptable method of hysterectomy. The objective of present study was to compare the operating time, intraoperative and postoperative complications between VH and TAH in non-descent uterus. Methods: The study was conducted in the Department of Obstetrics Gynaecology for a period of 18months at Darbhanga Medical College & Hospital, Laheriasarai, Bihar. Results: Over the study period 100 patients were taken, 50 patients underwent non-descent vaginal hysterectomy andlabelled as group A and 50 patients were under went total abdominal hysterectomy and labelled as group B. It wasseen that intraoperative complications and postoperative complications were less in group A patients and operating time is also less with group A patients when compared with group B patients. Conclusions: From the present study, it was concluded that NDVH is associated with less blood loss during surgery, quicker recovery, and early mobilization, less operative and less postoperative morbidity when compared to TAH. NDVH is a less invasive technique with shorter hospital stay and faster convalescence.


2016 ◽  
Vol 23 (02) ◽  
pp. 166-170
Author(s):  
Zohra Kahnum ◽  
Amna Kahnum ◽  
Aman ur Rehman ◽  
Liaqat Ali

Introduction: In current era, the trend for minimal invasive surgery is increaseddue to its established advantages. With the same, there increasing trend for laparoscopichysterectomy. But it carries certain risks in certain situations. Objectives: The study wasconducted to see the outcome of laparoscopic hysterectomies. Study Design: Retrospective,analytic study. Study Period: June 2012 to May, 2015. Method: A study was conducted to reviewthe outcome of Laparoscopic hysterectomy over a period of three years from June 2012 to May2015. Total one hundred cases were included in the study. These patients had hysterectomyeither total laparoscopic hysterectomy or laparoscopic assisted vaginal hysterectomy. Afterpreoperative evaluation, hysterectomy was done either total laparoscopic or laparoscopicassisted vaginal hysterectomy. Data was collected regarding patients profile variables,indications for hysterectomy, intraoperative findings, intraoperative time, postoperative recoveryfindings, analgesia requirements and discharge time from the hospital. Results: Results of thestudy showed that there was no significant increase in complication of urinary tract or bowelinjury. Operative time was decreased with time. Most common indication for hysterectomywas fibroid uterus or dysfunctional uterine bleeding. Patient recovery was smooth and postoperativeanalgesia was much less as compared to the routine. Patient hospital stay was lessas compared to the routine procedures for hysterectomy. Conclusion: It is concluded fromthe study that laparoscopic hysterectomy is safe procedure with the clear advantages for thepatient. In the study complication rate, operating time was comparable to the already publishedstudies. With proper training it is acceptable alternate to abdominal hysterectomy with clearadvantages for the patient.


Author(s):  
Anchala Mahilange

Background: Hysterectomy is the most common gynaecological surgical procedure after caesarean section. In India there is lower rate (4-6%) of hysterectomy has been reported, while there is higher frequency of hysterectomy (10-20%) in developed countries. Currently there are three main types of hysterectomy operations in practice for benign diseases abdominal hysterectomy, vaginal hysterectomy and laparoscopic hysterectomy. Abdominal hysterectomy remains the predominant method of uterus removal. The present study was planned t to analyse changes in the trends of hysterectomy from past 3 year in the study area.Methods: The present observational study was conducted in department of obstetrics and gynaecology and associated Dr. B.R.A.M. hospital Raipur (CG), India. Data was collected retrospectively from January 2009 to May 2012 from hospital medical records. Prospectively data was obtained from patient and his file from June 2013 to September 2014. Data was compiled in MS-excel and checked for its completeness and correctness, and then it was analyzed by using suitable software.Results: Total no of hysterectomy conducted in study duration was 1000. Study showed declining trend of hysterectomy in our institute. Most common age group of hysterectomy was 41-50 year. which 45.8% followed by age group 31-40 that is 32.5%. Most common indication of hysterectomy was fibroid uterus 33.6% followed by prolapse uterus 29.5%. 29% cases were operated via vaginal route for descent of uterus and 21% cases operated by vaginal route for non-descent uterus.50% cases were operated via abdominal route. Average operating time for TAH was 1.43±0.50, for VH was 1.08±0.03. Average hospital stay for TAH was 8.87±3.31 and VH was 5.27±1.07. Conclusions: In our study it had been seen that rate of hysterectomy is in decreasing trend as more conservative approach is now preferred. To minimize most of complications of hysterectomy second opinion fresh eyes and multi-disciplinary approach is recommend in all patients undergoing this procedure.


2018 ◽  
Vol 13 (3) ◽  
pp. 32-36
Author(s):  
Suman Raj Tamrakar ◽  
N. Pradhan ◽  
Suresh Kayastha

Aims: The aim of this study is to assess learning curves for laparoscopic hysterectomies, compare the performance of surgeons and review demographic parameters of the patients, varieties of complications experienced and indications of the procedures. Methods: A retrospective study was conducted in Kathmandu University Hospital, Kavre of January 1, 2011 to June 30, 2018. Results: A total of 1849 cases were already performed by mid 2018. Of them, 261 (14.12%) cases were LAVH and TLH cases. Mean duration for laparoscopic hysterectomies (for both LAVH and TLH) was 142.21±43.46 minutes (range 55 to 310 minutes) and one third of the cases performed in a range of 121 to 150 minutes. There is difference in mean duration of operation between surgeons which is statistically significant (p <0.001). Beside one of four surgeons (surgeon B) had significant reduction in mean duration for LAVH surgery (p=0.004). Same surgeon has significant reduction in mean duration for performing TLH (p=0.0047). Of the 261 laparoscopic hysterectomies, 8 cases (3.07%) turned into laparotomy. Conclusions: Laparoscopic hysterectomies are feasible with reducing mean operating time across the period. These minimal invasive surgeries are safe with low rate of complications and less conversion to open even in our set up.


2019 ◽  
Vol 4 (3) ◽  

Hospital Infection control is very essential for the safety and wellbeing of patients, hospital staffs and visitors of the hospital. It affects various Departments of the hospital and it also involves problems of quality risk management, clinical governance of health and safety. Many factors stimulate infections among hospitalized patients – ‘decreased resistance among patients’; ‘increasing variation of medical procedures’ and ‘invasive techniques crafting potential routes of infection’; and ‘the transmission of drug-resistant bacteria’ are packed among hospital populations’, where poor practice in infection control may facilitate transmission. Audit means checking actual practice against a standard; it should permit reporting of noncompliance or issues of concern by either healthcare workers (HCW) or the Infection Control Team (ICT). Providing results of the audit to staff enables them to identify where improvement is needed.1 Audit is a quality improvement process that seeks to improve patient care and outcomes through systematic review of care compared with explicit criteria and the subsequent implementation of change.


Author(s):  
Kanmani M. ◽  
Mirudhubashini Govindarajan ◽  
Vishranthi Selvaraj

Background: Since the introduction of Laparoscopic hysterectomy by Reich in 1989, it has become a widely accepted technique worldwide. The aim of the study was to compare the surgical results between Total Laparoscopic Hysterectomy (TLH) and Total Abdominal Hysterectomy (TAH).Methods: We conducted a retrospective study at Women’s center and hospitals between June 2014 to May 2016, 32 patients who underwent TAH and 55 patients who underwent TLH, were included.Results: We observed that there was no significant difference between the two groups in respect to patient's demographic characteristics, indication of surgery, uterine size, or with history of previous pelvic surgery. Duration of surgery was found to be longer in TLH than TAH (124±39.7 min vs. 104.7±39.8 min). The length of hospital stay was less in TLH than TLH (P-0.0001) and the amount of blood loss were also less in TLH than TAH (103±149 ml versus 243±210 ml). There was no significant difference in view of intra and post operative complications. Hemoglobin change was statistically significant and is more with TAH than TLH (1.57±0.7g% versus 1.12±0.7g%).Conclusions: This study showed that TLH can be safely performed by the experienced surgeon in order to reduce the blood loss, duration of hospital stay and the quality of life.


Author(s):  
Renato Seracchioli ◽  
Stefano Venturoli ◽  
Federico Vianello ◽  
Francesca Govoni ◽  
Marianna Cantarelli ◽  
...  

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