INTRODUCTION: Hysterectomy remains the most common major
gynecological operation. This is the first study that describes a
new technique of TLH without using any kind of uterine manipulator
or vaginal tube (TLHwM) and analyzes the intra- and postoperative
surgical outcome of the first 67 cases.
PATIENTS AND METHODS: Between October 2008 and December 2009, 67
patients underwent TLH without uterine manipulator or vaginal tube.
We analyzed the differences in the outcome by using three different
kinds of surgical instruments: in 21 cases the TLHwM was performed
using conventional 5 mm bipolar and scissors, in 22 cases using
Sonosurgical, and in 24 cases using PKS cutting forceps.
RESULTS: There was no intra- or postoperative complications. The
overall mean operating time was by TLHwM with salpingo-oophorectomy
98 min and without salpingo-oophorectomy, 80 min. The mean
operating time using cutting forceps was significantly lower. The
mean uterine weight was 263 g.
DISCUSSION: Uterine manipulator seems to be a safe and practical
surgical method, especially for patients with vaginal stenosis and
in cases of enlarged uterus. With its short operation time and no
complication rate, we believe that this method is an enrichment of
the laparoscopic hysterectomy techniques.
PMID: 20449598 [PubMed – indexed for MEDLINE]