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Kowalczyk D, Piątkowski S, Porażko M, Woskowska A, Szewczyk K, Brudniak K, Wójtowicz M, Kowalczyk K. Safety of Three-Dimensional versus Two-Dimensional Laparoscopic Hysterectomy during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14163. [PMID: 36361054 PMCID: PMC9654606 DOI: 10.3390/ijerph192114163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 10/20/2022] [Accepted: 10/24/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND The COVID-19 pandemic has resulted in a significant decrease in the number of surgical procedures performed. Therefore, it is important to use surgical methods that carry the lowest possible risk of virus transmission between the patient and the operating theater staff. AIM Safety evaluation of three-dimensional (3D) versus two-dimensional (2D) laparoscopic hysterectomy during the COVID-19 pandemic. METHODS 44 patients were assigned to a prospective case-control study. They were divided either to 3D (n = 22) or 2D laparoscopic hysterectomy (n = 22). Fourteen laparoscopic supracervical hysterectomies (LASH) and eight total laparoscopic hysterectomies (TLH) were performed in every group. The demographic data, operating time, change in patients' hemoglobin level and other surgical outcomes were evaluated. RESULTS 3D laparoscopy was associated with a significantly shorter operating time than 2D. (3D vs. 2D LASH 70 ± 23 min vs. 90 ± 20 min, p = 0.0086; 3D vs. 2D TLH 72 ± 9 min vs. 85 ± 9 min, p = 0.0089). The 3D and 2D groups were not significantly different in terms of change in serum hemoglobin level and other surgical outcomes. CONCLUSIONS Due to a shorter operating time, 3D laparoscopic hysterectomy seems to be a safer method both for both the surgeon and the patient. Regarding terms of possible virus transmission, it may be particularly considered the first-choice method during the COVID-19 pandemic.
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Affiliation(s)
- Dariusz Kowalczyk
- Department of Anatomy, School of Medicine in Opole, University of Opole, 45-052 Opole, Poland
| | - Szymon Piątkowski
- Students’ Scientific Association of Gynecology and Obstetrics, School of Medicine in Opole, University of Opole, 45-052 Opole, Poland
| | - Maja Porażko
- Students’ Scientific Association of Gynecology and Obstetrics, School of Medicine in Opole, University of Opole, 45-052 Opole, Poland
| | - Aleksandra Woskowska
- Students’ Scientific Association of Gynecology and Obstetrics, School of Medicine in Opole, University of Opole, 45-052 Opole, Poland
| | - Klaudia Szewczyk
- Students’ Scientific Association of Gynecology and Obstetrics, School of Medicine in Opole, University of Opole, 45-052 Opole, Poland
| | - Katarzyna Brudniak
- Students’ Scientific Association of Gynecology and Obstetrics, School of Medicine in Opole, University of Opole, 45-052 Opole, Poland
| | - Mariusz Wójtowicz
- Department of Gynecological and Obstetrics Women’s and Child Health Center, Medical University of Silesia, 41-803 Zabrze, Poland
| | - Karolina Kowalczyk
- Department of Endocrinological Gynecology, Faculty of Medicine in Katowice, Medical University of Silesia, 40-752 Katowice, Poland
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Millet P, Gauthier T, Vieillefosse S, Dewaele P, Rivain AL, Legendre G, Golfier F, Touboul C, Deffieux X. Should we perform cervix removal during hysterectomy for benign uterine disease? Clinical practice guidelines from the French College of Gynecologists and Obstetricians (CNGOF). J Gynecol Obstet Hum Reprod 2021; 50:102134. [PMID: 33794370 DOI: 10.1016/j.jogoh.2021.102134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 03/25/2021] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To provide guidelines from the French College of Obstetricians and Gynecologists (CNGOF), based on the best evidence available, concerning subtotal or total hysterectomy, for benign disease. METHODS The CNGOF has decided to adopt the AGREE II and GRADE systems for grading scientific evidence. Each recommendation for practice was allocated a grade, which depends on the quality of evidence (QE) (clinical practice guidelines). RESULTS Conservation of the uterine cervix is associated with an increased risk of cervical cancer (0.05 to 0.27%) and an increased risk of reoperation for cervical bleeding (QE: high). Uterine cervix removal is associated with a moderate (about 11 min) increase in operative time when hysterectomy is performed by the open abdominal route (laparotomy), but is not associated with longer operative time when the hysterectomy is performed by laparoscopy (QE: moderate). Removal of the uterine cervix is not associated with increased prevalence of short-term follow-up complications (blood transfusion, ureteral or bladder injury) (QE: low) or of long-term follow-up complications (pelvic organ prolapse, sexual disorders, urinary incontinence (QE: moderate). CONCLUSION Removal of the uterine cervix is recommended for hysterectomy in women presenting with benign uterine disease (Recommendation: STRONG [GRADE 1-]; the level of evidence was considered to be sufficient and the risk-benefit balance was considered to be favorable).
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Affiliation(s)
- Pierre Millet
- APHP, GHU South, Antoione Béclere Hospital, Department of Obstetrics and Gynaecology, 157 rue de la porte de Trivaux, F-92140, Clamart, France
| | - Tristan Gauthier
- Département de Gynécologie et Obstétrique, CHU Limoges, 8 av Dominique Larrey, 87000 Limoges, France; INSERM, UMR-1248, CHU Limoges, 87000 Limoges, France
| | - Sarah Vieillefosse
- APHP, GHU South, Antoione Béclere Hospital, Department of Obstetrics and Gynaecology, 157 rue de la porte de Trivaux, F-92140, Clamart, France
| | - Pauline Dewaele
- APHP, GHU South, Antoione Béclere Hospital, Department of Obstetrics and Gynaecology, 157 rue de la porte de Trivaux, F-92140, Clamart, France
| | - Anne-Laure Rivain
- APHP, GHU South, Antoione Béclere Hospital, Department of Obstetrics and Gynaecology, 157 rue de la porte de Trivaux, F-92140, Clamart, France
| | - Guillaume Legendre
- CHU Angers, Department of Obstetrics and Gynaecology, F-49000, Angers, France
| | - François Golfier
- CHU Lyon, Department of Obstetrics and Gynaecology, F-69000, Lyon, France
| | - Cyril Touboul
- APHP, GHU East, Tenon Hospital, Department of Obstetrics and Gynaecology, 4 rue de la Chine, F-75020, Paris, France
| | - Xavier Deffieux
- APHP, GHU South, Antoione Béclere Hospital, Department of Obstetrics and Gynaecology, 157 rue de la porte de Trivaux, F-92140, Clamart, France; University Paris-Saclay, Faculté de Médecine, F94270, Le Kremlin-Bicêtre, France.
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Beyan E, Kanmaz AG, Budak A, Emirdar V, Tutar SO, Inan AH. Uterine manipulator requirement in laparoscopic surgery of Ectopic Pregnancy. Pak J Med Sci 2020; 36:105-110. [PMID: 32063941 PMCID: PMC6994866 DOI: 10.12669/pjms.36.2.1294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Objective: The advantages of laparoscopic surgery used in the treatment of ectopic pregnancy is well-known; however, the efficacy of uterine manipulators remains unknown. In this study, we aimed to investigate the efficacy of uterine manipulators in the laparoscopic treatment of ectopic pregnancy. Methods: Overall, 118 patients who underwent laparoscopy due to ectopic pregnancy in Department of Obstetrics and Gynaecology at Tepecik Education and Research Hospital between January 2010 and January 2018 and who met the inclusion criteria were included in the study. Groups of patients undergoing surgery with or without the use of a uterine manipulator were compared in terms of demographic data, operative and postoperative results. Results: No difference was noted between the groups in terms of age, parity, body mass index, smoking, side of ectopic pregnancy mass, previous operations and pregnancy type. However, the size of ectopic pregnancy mass measured by ultrasonography was significantly larger (p = 0.006) and the operation time was significantly shorter (p<0.001) in the group where uterine manipulators were not used than in the uterine manipulator group. Conclusion: We concluded that not using a uterine manipulator in laparoscopic procedures for ectopic pregnancy did not increase operative complications and that operation time was higher in procedures using uterine manipulators.
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Affiliation(s)
- Emrah Beyan
- Dr. Emrah Beyan, MD. Department of Obstetrics and Gynecology, Tepecik Education and Research Hospital, Izmir, Turkey
| | - Ahkam Goksel Kanmaz
- Dr. Ahkam Goksel Kanmaz, MD. Department of Obstetrics and Gynecology, Tepecik Education and Research Hospital, Izmir, Turkey
| | - Adnan Budak
- Dr. Adnan Budak, MD. Department of Obstetrics and Gynecology, Tepecik Education and Research Hospital, Izmir, Turkey
| | - Volkan Emirdar
- Dr. Volkan Emirdar, MD. Department of Obstetrics and Gynecology, Medical Park Hospital, Izmir, Turkey
| | - Sadettin Oguzhan Tutar
- Dr. Sadettin Oguzhan Tutar, MD. Department of Obstetrics and Gynecology, Ardahan State Hospital, Ardahan, Turkey
| | - Abdurrahman Hamdi Inan
- Dr. Abdurrahman Hamdi Inan, MD. Department of Obstetrics and Gynecology, Bornova Turkan Ozilhan State Hospital, Izmir, Turkey
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Tran AQ, Greene N, Cass I. The Impact of Annual Surgical Volume on Patient Outcomes in Laparoscopic Hysterectomy. J Gynecol Surg 2018. [DOI: 10.1089/gyn.2017.0113] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Arthur-Quan Tran
- Department of Obstetrics and Gynecology, Cedars–Sinai Medical Center, Los Angeles, CA
| | - Naomi Greene
- Department of Obstetrics and Gynecology, Cedars–Sinai Medical Center, Los Angeles, CA
| | - Ilana Cass
- Department of Obstetrics and Gynecology, Cedars–Sinai Medical Center, Los Angeles, CA
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Abdusattarova K, Mettler L, Alkatout I, Dempfle A. Endoscopic treatment of symptomatic fibroids at reproductive age and beyond. MINIM INVASIV THER 2017; 26:355-361. [DOI: 10.1080/13645706.2017.1312457] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Khulkar Abdusattarova
- Department of Gynecology and Obstetrics, University Clinic Schleswig-Holstein, Kiel, Germany
| | - Liselotte Mettler
- Department of Gynecology and Obstetrics, University Clinic Schleswig-Holstein, Kiel, Germany
| | - Ibrahim Alkatout
- Department of Gynecology and Obstetrics, University Clinic Schleswig-Holstein, Kiel, Germany
| | - Astrid Dempfle
- Institute of Medical Informatics and Statistics, University Hospital Schleswig-Holstein, Kiel, Germany
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7
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Peritoneal closure during laparoscopic supracervical hysterectomy. Arch Gynecol Obstet 2016; 294:785-9. [DOI: 10.1007/s00404-016-4125-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2016] [Accepted: 05/19/2016] [Indexed: 10/21/2022]
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8
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Hysterectomy for benign disease: clinical practice guidelines from the French College of Obstetrics and Gynecology. Eur J Obstet Gynecol Reprod Biol 2016; 202:83-91. [PMID: 27196085 DOI: 10.1016/j.ejogrb.2016.04.006] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2016] [Revised: 03/30/2016] [Accepted: 04/02/2016] [Indexed: 12/11/2022]
Abstract
OBJECTIVE The objective of the study was to draw up French College of Obstetrics and Gynecology (CNGOF) clinical practice guidelines based on the best available evidence concerning hysterectomy for benign disease. METHODS Each recommendation for practice was allocated a grade, which depends on the level of evidence (clinical practice guidelines). RESULTS Hysterectomy should be performed by a high-volume surgeon (>10 hysterectomy procedures per year) (gradeC). Stimulant laxatives taken as a rectal enema are not recommended prior to hysterectomy (gradeC). It is recommended to carry out vaginal disinfection using povidone-iodine solution prior to hysterectomy (grade B). Antibiotic prophylaxis is recommended during hysterectomy, regardless of the surgical approach (grade B). The vaginal or laparoscopic approach is recommended for hysterectomy for benign disease (grade B), even if the uterus is large and/or the patient is obese (gradeC). The choice between these two surgical approaches depends on other parameters, such as the surgeon's experience, the mode of anesthesia, and organizational constraints (duration of surgery and medical economic factors). Vaginal hysterectomy is not contraindicated in nulliparous women (gradeC) or in women with previous cesarean section (gradeC). No specific hemostatic technique is recommended with a view to avoiding urinary tract injury (gradeC). In the absence of ovarian disease and a personal or family history of breast/ovarian carcinoma, the ovaries should be preserved in pre-menopausal women (grade B). Subtotal hysterectomy is not recommended with a view to reducing the risk of peri- or postoperative complications (grade B). CONCLUSION The application of these recommendations should minimize risks associated with hysterectomy.
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Marcelli M, Gauthier T, Chêne G, Lamblin G, Agostini A. Complications associées à l’hystérectomie : place de l’hystérectomie subtotale, prévention thromboembolique et traitements préopératoires : recommandations. ACTA ACUST UNITED AC 2015; 44:1206-18. [DOI: 10.1016/j.jgyn.2015.09.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2015] [Accepted: 09/18/2015] [Indexed: 01/05/2023]
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11
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Bruneau L, Randet M, Evrard S, Damon A, Laurent FX. Prise en charge ambulatoire de l’hystérectomie laparoscopique : évaluation de la faisabilité et de la satisfaction des patientes. ACTA ACUST UNITED AC 2015; 44:870-6. [DOI: 10.1016/j.jgyn.2015.02.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2014] [Revised: 01/18/2015] [Accepted: 02/11/2015] [Indexed: 11/25/2022]
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12
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Chêne G, Lamblin G, Marcelli M, Huet S, Gauthier T. [Urinary, infectious and digestive adverse events related to benign hysterectomy and the associated surgery on the Fallopian tube: Guidelines]. ACTA ACUST UNITED AC 2015; 44:1183-205. [PMID: 26527024 DOI: 10.1016/j.jgyn.2015.09.031] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2015] [Accepted: 09/18/2015] [Indexed: 12/22/2022]
Abstract
OBJECTIVES To provide clinical practice guidelines from the French College of Obstetrics and Gynecology (CNGOF) based on the best evidence available, concerning the urinary, infectious and digestive adverse events related to benign hysterectomy and the associated surgery including opportunistic salpingectomy and adnexectomy. MATERIAL AND METHOD Review of literature using following keywords: benign hysterectomy; urinary injury; bladder injury; ureteral injury; vesicovaginal fistula; infection; bowel injury; salpingectomy. RESULTS Urinary catheter should be removed before 24h following uncomplicated hysterectomy (grade B). In case of urinary catheter during hysterectomy, immediate postoperative removal is possible (grade C). No hemostasis technics can be recommended to avoid urinary injury (grade C). There is not any evidence to recommend to perform a window in the broad ligament or an ureterolysis, to put ureteral stent or a uterine manipulator in order to avoid ureteral injury. An antibiotic prophylaxis by a cephalosporin is always recommended (grade B). Mechanical bowel preparation before hysterectomy is not recommended (grade B). If there is no ovarian cyst/disease and no familial or personal history of ovarian/breast cancer, ovarian conservation is recommended in premenopausal women (grade B). In postmenopausal women, informed consent and surgical approach should be taken in account to perform a salpingo-oophorectomy. Since the association salpingectomy and hysterectomy is not assessed in the prevention of ovarian cancer, systematic bilateral salpingectomy is not recommended (expert consensus). CONCLUSIONS Practical application of these guidelines should decrease the prevalence of visceral complications associated with benign hysterectomy.
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Affiliation(s)
- G Chêne
- Département de gynécologie-obstétrique, hôpital Femme-Mère-Enfant, HFME, hospices civils de Lyon, 69002 Lyon, France; Université Claude-Bernard Lyon 1, EMR 3738, 69100 Villeurbanne, France.
| | - G Lamblin
- Département de gynécologie-obstétrique, hôpital Femme-Mère-Enfant, HFME, hospices civils de Lyon, 69002 Lyon, France
| | - M Marcelli
- Département de gynécologie-obstétrique, hôpital La Conception, Aix-Marseille université, 13005 Marseille, France
| | - S Huet
- Département de gynécologie-obstétrique, hôpital Mère-Enfant, CHU de Limoges, avenue Larrey, 87000 Limoges, France
| | - T Gauthier
- Département de gynécologie-obstétrique, hôpital Mère-Enfant, CHU de Limoges, avenue Larrey, 87000 Limoges, France
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Maclaran K, Agarwal N, Odejinmi F. Perioperative outcomes in laparoscopic hysterectomy: identifying surgical risk factors. ACTA ACUST UNITED AC 2015. [DOI: 10.1007/s10397-015-0914-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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14
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Berner E, Qvigstad E, Myrvold AK, Lieng M. Pain reduction after total laparoscopic hysterectomy and laparoscopic supracervical hysterectomy among women with dysmenorrhoea: a randomised controlled trial. BJOG 2015; 122:1102-11. [DOI: 10.1111/1471-0528.13362] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/23/2014] [Indexed: 11/28/2022]
Affiliation(s)
- E Berner
- Department of Gynaecology; Oslo University Hospital; Oslo Norway
| | - E Qvigstad
- Department of Gynaecology; Oslo University Hospital; Oslo Norway
- Institute of Clinical Medicine; University of Oslo; Oslo Norway
| | - AK Myrvold
- Department of Pathology; Oslo University Hospital; Oslo Norway
| | - M Lieng
- Department of Gynaecology; Oslo University Hospital; Oslo Norway
- Institute of Clinical Medicine; University of Oslo; Oslo Norway
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Comparison of reoperation rates, perioperative outcomes in women with endometrial cancer when the standard of care shifts from open surgery to laparoscopy. Arch Gynecol Obstet 2014; 290:1215-20. [DOI: 10.1007/s00404-014-3347-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2013] [Accepted: 06/27/2014] [Indexed: 10/25/2022]
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Urinary Tract Injuries in Laparoscopic Hysterectomy: A Systematic Review. J Minim Invasive Gynecol 2014; 21:558-66. [DOI: 10.1016/j.jmig.2014.01.006] [Citation(s) in RCA: 89] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2013] [Revised: 12/28/2013] [Accepted: 01/06/2014] [Indexed: 11/23/2022]
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Pelvic Pain and Patient Satisfaction After Laparoscopic Supracervical Hysterectomy: Prospective Trial. J Minim Invasive Gynecol 2014; 21:406-11. [DOI: 10.1016/j.jmig.2013.10.011] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2013] [Revised: 10/22/2013] [Accepted: 10/23/2013] [Indexed: 11/18/2022]
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Unanticipated Uterine Pathologic Finding After Morcellation During Robotic-Assisted Supracervical Hysterectomy and Cervicosacropexy for Uterine Prolapse. Female Pelvic Med Reconstr Surg 2014; 20:113-5. [DOI: 10.1097/spv.0b013e31829ff5b8] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Brucker S, Rothmund R, Krämer B, Neis F, Schönfisch B, Zubke W, Taran FA, Wallwiener M. Cervical Detachment Using Monopolar SupraLoop™ Electrode versus Monopolar Needle in Laparoscopic Supracervical Hysterectomy (LSH): An Interventional, Comparative Cohort Study. Geburtshilfe Frauenheilkd 2013; 73:1121-1127. [PMID: 24771898 DOI: 10.1055/s-0033-1350975] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2013] [Revised: 09/12/2013] [Accepted: 10/07/2013] [Indexed: 10/25/2022] Open
Abstract
Objective: Currently available monopolar loop electrodes are difficult to handle in laparoscopic supracervical hysterectomy (LSH) and are entirely disposable devices, generating additional operating costs. The aim of this interventional study was the comparison of the efficiency and safety of cervical detachment with a newly developed monopolar loop electrode (SupraLoop™) with a conventional method of cervical detachment in LSH. Material and Methods: Our study sample included 1598 patients; 1070 patients that underwent LSH with cervical detachment using the monopolar SupraLoop™ (study group) and 528 patients that underwent LSH with cervical detachment using the monopolar needle (control group). We also assessed cervical detachment time and total device application and cutting time in a subgroup of 49 patients (23 patients from the study group and 26 patients from the control group). Results: Total operation time for LSH was significantly shorter among SupraLoop™ patients (93 ± 41 minutes) when compared to patients in whom cervical detachment was performed with the needle (105 ± 44 minutes) (p < 0.001). Cervical detachment time and total device application including cutting time was significantly shorter for the SupraLoop™ group (SupraLoop vs. needle; 0.12 ± 0.21 min vs. 5.1 ± 4.4 min [p < 0.001]; 2.3 ± 1.8 min vs. 5.4 ± 2.4 min [p < 0.001]). There were no major or minor complications directly related to the use of the SupraLoop™ device, whereas two intraoperative complications were directly related to the application of the monopolar needle. Conclusion: The newly developed monopolar loop electrode (SupraLoop™) is both an effective and safe instrument for cervical detachment in laparoscopic supracervical hysterectomy, and performed better than the needle, offering a significantly shorter operating time and less complications for the hysterectomy compared to the conventional method.
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Affiliation(s)
- S Brucker
- Women's Clinic, University Tübingen, Tübingen
| | - R Rothmund
- Women's Clinic, University Tübingen, Tübingen
| | - B Krämer
- Women's Clinic, University Tübingen, Tübingen
| | - F Neis
- Women's Clinic, University Tübingen, Tübingen
| | | | - W Zubke
- Women's Clinic, University Tübingen, Tübingen
| | - F A Taran
- Women's Clinic, University Tübingen, Tübingen
| | - M Wallwiener
- Women's Clinic Heidelberg, University Heidelberg, Heidelberg
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Bardens D, Solomayer E, Baum S, Radosa J, Gräber S, Rody A, Juhasz-Böss I. The impact of the body mass index (BMI) on laparoscopic hysterectomy for benign disease. Arch Gynecol Obstet 2013; 289:803-7. [DOI: 10.1007/s00404-013-3050-2] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2013] [Accepted: 09/30/2013] [Indexed: 11/29/2022]
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Laparoscopic supracervical hysterectomy (LSH) versus total laparoscopic hysterectomy (TLH): an implementation study in 1,952 patients with an analysis of risk factors for conversion to laparotomy and complications, and of procedure-specific re-operations. Arch Gynecol Obstet 2013; 288:1329-39. [PMID: 23775263 DOI: 10.1007/s00404-013-2921-x] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2012] [Accepted: 05/02/2013] [Indexed: 02/06/2023]
Abstract
PURPOSE To compare laparoscopic supracervical hysterectomy (LSH) with total laparoscopic hysterectomy (TLH) with regard to relevant surgical parameters and risk factors of conversion to laparotomy and complications. METHODS This prospective, open, single-center, interventional study included women with benign gynecologic disease who underwent standardized LSH or TLH. The techniques were compared for conversion rate and mean operating time, hemoglobin drop, hospital stay, and complication rates using descriptive statistics and standard non-parametric statistical tests. Risk factors of conversion and complications were identified by logistic regression analysis. RESULTS During January 2003 to December 2010, 1,952 women [mean age (SD): 47.5 (7.2) years] underwent LSH [1,658 (84.9%)] or TLH [294 (15.1%)], mostly (>70%) for uterine fibroids. Significant differences in surgical parameters were observed for conversion rate (LSH/TLH: 2.6/6.5%), mean operating time [87 (34)/103 (36) min], hemoglobin drop [1.3 (0.8)/1.6 (1.0) g/dL], and hospital stay [4.3 (1.5)/4.9 (2.8) days]. Overall intraoperative (0.2/0.7%) and long-term (>6 weeks) post-operative (0.8/1.7%) complication rates did not differ significantly, but the short-term LSH complication rate was significantly lower (0.6 vs. 4.8%). Spotting (LSH, 0.2%) and vaginal cuff dehiscence (TLH, 0.7%) were long-term method-specific complications. Logistic regression showed that uterine weight and extensive adhesiolysis were significant factors for conversion while previous surgery, age, and BMI were not. Major risk factors of short-term complications were age, procedure (LSH/TLH), and extensive adhesions. CONCLUSIONS Both procedures proved effective and were well tolerated. LSH performed better than TLH regarding most outcome measures. LSH is associated with very low rates of re-operation and spotting.
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Mild hydronephrosis after uncomplicated hysterectomy. Eur J Obstet Gynecol Reprod Biol 2013; 168:102-6. [PMID: 23351669 DOI: 10.1016/j.ejogrb.2012.12.041] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2012] [Revised: 12/06/2012] [Accepted: 12/29/2012] [Indexed: 11/22/2022]
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Berner E, Qvigstad E, Langebrekke A, Lieng M. Laparoscopic Supracervical Hysterectomy Performed With and Without Excision of the Endocervix: A Randomized Controlled Trial. J Minim Invasive Gynecol 2013; 20:368-75. [DOI: 10.1016/j.jmig.2013.01.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2012] [Revised: 01/14/2013] [Accepted: 01/16/2013] [Indexed: 10/27/2022]
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Bardens D, Solomayer E, Baum S, Rody A, Juhasz-Böss I. Comparison of Total and Supracervical Laparoscopic Hysterectomy for Benign Disease in a Collective of 200 Patients. J Gynecol Surg 2012. [DOI: 10.1089/gyn.2012.0016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- David Bardens
- Department of Obstetrics and Gynecology, Saarland University Clinic, Homburg/Saar, Germany
| | - Erich Solomayer
- Department of Obstetrics and Gynecology, Saarland University Clinic, Homburg/Saar, Germany
| | - Sascha Baum
- Department of Obstetrics and Gynecology, Saarland University Clinic, Homburg/Saar, Germany
| | - Achim Rody
- Department of Obstetrics and Gynecology, Saarland University Clinic, Homburg/Saar, Germany
| | - Ingolf Juhasz-Böss
- Department of Obstetrics and Gynecology, Saarland University Clinic, Homburg/Saar, Germany
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Prospective evaluation of surgical outcomes of robot-assisted sacrocolpopexy and sacrocervicopexy for the management of apical pelvic support defects. South Med J 2012; 105:274-8. [PMID: 22561541 DOI: 10.1097/smj.0b013e318254d0c6] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To evaluate outcomes of robot-assisted sacrocolpopexy (RSCP) and sacrocervicopexy (RCSP). METHODS We conducted a prospective study of women undergoing RSCP or RCSP between June 2008 and January 2010. RESULTS A total of 85 cases (48 RSCP and 37 supracervical hysterectomy with concomitant RCSP) were performed: 33% (28/85) for stage II, 54% (46/85) for stage III, and 13% (11/85) for stage IV pelvic organ prolapse (POP). Six weeks postoperatively, 96% (80/83) had stage 0, 2.4% (2/83) had stage I, and 1.2% (1/83) had stage II POP (P < 0.001). Six months postoperatively, 77% (24/31) had stage 0, 6.5% (2/31) had stage I, and 16% (5/31) had stage II POP (P < 0.001). Mean surgical time, estimated blood loss, and length of hospital stay was 194 ± 54 minutes, 49 ± 48 cm, and 1.6 ± 0.72 days, respectively. There were 2 cases of mesh erosion (2.3%), both in the RSCP group. CONCLUSIONS RSCP and RCSP are effective, efficient, and safe procedures.
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Laparoscopic supracervical hysterectomy: impact of body mass index and uterine weight. ACTA ACUST UNITED AC 2011. [DOI: 10.1007/s10397-011-0721-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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27
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Place de l’hystérectomie supracervicale et de l’abord cœlioscopique pour fibromes symptomatiques. ACTA ACUST UNITED AC 2011; 40:944-52. [DOI: 10.1016/j.jgyn.2011.09.027] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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28
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Boosz A, Lermann J, Mehlhorn G, Renner SP, Thiel FC, Hartmann A, Beckmann MW, Mueller A. Is Laparoscopic Extirpation of the Cervical Stump After Laparoscopic Supracervical Hysterectomy Justified in Women with Incidentally Found Atypical Endometrial Hyperplasia? J Laparoendosc Adv Surg Tech A 2011; 21:705-9. [DOI: 10.1089/lap.2010.0497] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Alexander Boosz
- Department of Obstetrics and Gynecology, Erlangen University Hospital, University of Erlangen–Nuremberg, Erlangen, Germany
| | - Johannes Lermann
- Department of Obstetrics and Gynecology, Erlangen University Hospital, University of Erlangen–Nuremberg, Erlangen, Germany
| | - Grit Mehlhorn
- Department of Obstetrics and Gynecology, Erlangen University Hospital, University of Erlangen–Nuremberg, Erlangen, Germany
| | - Stefan P. Renner
- Department of Obstetrics and Gynecology, Erlangen University Hospital, University of Erlangen–Nuremberg, Erlangen, Germany
| | - Falk C. Thiel
- Department of Obstetrics and Gynecology, Erlangen University Hospital, University of Erlangen–Nuremberg, Erlangen, Germany
| | - Arndt Hartmann
- Department of Pathology, University of Erlangen–Nuremberg, Erlangen, Germany
| | - Matthias W. Beckmann
- Department of Obstetrics and Gynecology, Erlangen University Hospital, University of Erlangen–Nuremberg, Erlangen, Germany
| | - Andreas Mueller
- Department of Obstetrics and Gynecology, Erlangen University Hospital, University of Erlangen–Nuremberg, Erlangen, Germany
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Comparison of re-operation rates and complication rates after total laparoscopic hysterectomy (TLH) and laparoscopy-assisted supracervical hysterectomy (LASH). Eur J Obstet Gynecol Reprod Biol 2011; 158:269-73. [DOI: 10.1016/j.ejogrb.2011.04.021] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2010] [Revised: 03/08/2011] [Accepted: 04/27/2011] [Indexed: 11/22/2022]
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30
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The Hohl instrument for optimizing total laparoscopic hysterectomy: results of more than 500 procedures in a university training center. Arch Gynecol Obstet 2011; 285:123-7. [DOI: 10.1007/s00404-011-1905-y] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2011] [Accepted: 03/28/2011] [Indexed: 10/18/2022]
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31
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Hysterectomy-a comparison of approaches. DEUTSCHES ARZTEBLATT INTERNATIONAL 2010; 107:353-9. [PMID: 20539807 DOI: 10.3238/arztebl.2010.0353] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/22/2009] [Accepted: 10/05/2009] [Indexed: 11/27/2022]
Abstract
BACKGROUND The advantages and disadvantages of the various surgical techniques for hysterectomy are currently a topic of debate, with particular controversy over leaving the cervix in situ in the laparoscopic supracervical hysterectomy (LASH) procedure. METHODS In a retrospective single-center study, medical history and clinical characteristics were compared in patients who had undergone hysterectomy for benign disease in the period 2002-2008 at the Department of Obstetrics and Gynecology, Erlangen University Hospital. Postoperative satisfaction and the frequency of secondary operations for prolapse or incontinence in women with surgery between 2002 and 2007 were surveyed by means of a questionnaire. RESULTS The longest hospital stay was observed after abdominal hysterectomy (AH; 10 days), followed by vaginal hysterectomy (VH; 7.8 days) and laparoscopy-assisted vaginal hysterectomy (LAVH; 7.2 days). The shortest stays in hospital were seen after LASH (5.9 days) and total laparoscopic hysterectomy (TLH; 5.7 days). The shortest operating time was noted with VH (87 min) and the longest with LAVH (122 min). The lowest rates of blood loss were with LASH (1.38 g/dL) and TLH (1.51 g/dL). The highest rate of postoperative complications occurred after AH (8.9%). No differences were found in relation to postoperative satisfaction or surgery for prolapse or incontinence. CONCLUSION No postoperative benefits were found for leaving the cervix in situ when performing LASH. However, this was not a controlled randomized study.
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Yoon G, Kim TJ, Lee YY, Kim CJ, Choi CH, Lee JW, Kim BG, Bae DS. Single-port access subtotal hysterectomy with transcervical morcellation: a pilot study. J Minim Invasive Gynecol 2009; 17:78-81. [PMID: 19926345 DOI: 10.1016/j.jmig.2009.09.018] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2009] [Revised: 09/22/2009] [Accepted: 09/24/2009] [Indexed: 01/03/2023]
Abstract
We evaluated the feasibility, safety, and operative outcome of management of myomas and adenomyosis using single-port access subtotal hysterectomy with transcervical morcellation using a wound retractor and a surgical glove. We conclude the single-port access subtotal hysterectomy is safe and effective and results in almost no visible scar. With more experience and advanced instruments, this surgical procedure can offer a safe and effective option to hysterectomy with an excellent cosmetic outcome.
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Affiliation(s)
- Gun Yoon
- Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University, School of Medicine, Seoul, Korea
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