Laparoscopically assisted vaginal hysterectomy in a private clinic. First experience in costa rica

Abstract

A total of 30 procedures were begun as LAVH (Laparoscopic assited video hysterectomy) by Doderlein technique with 25 (83.3%) completed and 5 (16.7%) attempted but converted to an open aproach.

Indications were:

Leiomyata uteri 28 (93.3%)

Adenomiosis 5 (16.7%)

Menometrorrhagia 5 (16.7%)

Endometriosis 5 (16.7%)

Uterine prolapse 2 (6.68%)

Two complications ocurred (6.6%). One intraoperative large bowel perforation associated with extensive adhessions ocurred product of 2 previus laparotomy, and perforation was converted into an abdominal histerectomy. This perforation was repaired primarily. The second one was by the manipulation with the Diver in the vaginal approach and was repaired by vaginal way. This patient did not need posterior abdominal approach.

The other 4 abdominal hysterectomys was because important adhesions in the pelvis cavity whith bowel compromise that made imposible performance the Doder lain technique.

The average length of stay was 38.3 hours (range >68, <17). The author reviewed the general experience in Other countries with the laparoscopic procedures and the experience of introducing this new technique in a private clinic (Clínica Bíblica) and concluded that LAVH is efficasius ancl can be safely introduced in a CCSS National Hospital.

Results, including operating time, blood loss, subjetive feelings of nausea, emesis, oral tolerance, and resumption of ambulation were all evaluated in the inmediate postoperative period. All patients resumed their normal daily activities at 6 to IO days postoperatively.