Abstract
Abstract
Study Objective:
The aim of this study was to evaluate the efficacy and safety of total laparoscopic hysterectomy (TLH) by using the Ligasure™ system for the sealing of uterine arteries.
Design:
We conducted a retrospective review of cases who underwent TLH over 1.5 years.
Settings:
This study was conducted in a tertiary care hospital setting, at the Department of Obstetrics and Gynecology, All India Institute of Medical Sciences (New Delhi, India).
Patients:
A total of 110 patients of TLH done for uterine pathology [leiomyoma in 67 (60.9%), dysfunctional uterine bleeding in 34 (30.9%), and others in 9 (8.1%)].
Interventions:
Total laparoscopic hysterectomy, using the LigaSure system (Valleylab Inc., Boulder, CO), was done by the sealing of uterine arteries and Prashant Mangeshikar uterine manipulator for elevation of the uterus.
Results:
The mean age of the patients was 43.1 ± 0.602 years and mean body mass index was 25.19 ± 0.39 kg/m2. The mean operating time was 116.91 ± 3.4 minutes, mean intraoperative blood loss was 173.09 ± 11.64 mL, and the mean weight of the removed uterus was 224.14 ± 17.62 g. Six patients were converted from a laparoscopic to an open procedure (large myoma in 4 and dense adhesion in 2) and 1 was converted to laparoscopically assisted vaginal hysterectomy (tear in vaginal cuff). One patient (0.9%) developed lung emphysema during the intraoperative period. Postoperative complications included paralytic ileus in 3 (2.7%), retention of urine in 2 (1.8%), and febrile morbidity in 12 (10.9%) patients. There were no bladder or bowel injuries.
Conclusion:
Laparoscopic hysterectomy by uterine artery sealing with LigaSure is a safe, efficient procedure with a low complication rate.
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