Abstract

ARGUELLO-ARGUELLO, Ramiro. Complications in 748 laparoscopic hysterectomies using an uterine manipulator with vaginal highlighter. Rev Colomb Obstet Ginecol [online]. 2012, vol.63, n.3, pp.252-258. ISSN 0034-7434.

Introduction: Laparoscopic hysterectomy (LH) involves using a device which permits safe section of the vaginal dome. The present author has developed an uterine manipulator with vaginal highlighter (UM-VH) for this step. The present work has been aimed at presenting complications associated with using the UM-VH which have arisen during 10 years’ use. Materials and methods: This study involved a cohort of women undergoing laparoscopic hysterectomy using a UM-VH between December 7^th 1999 and June 21^st 2011. Inclusion criteria consisted of an indication of hysterectomy due to benign pathology. Females were excluded who had an indication of vaginal hysterectomy or where there was suspicion of excesively large uterine or intra-abdominal adherences. Age, parity, a background of prior caesarean sections or laparotomy, time spent in surgery, the weight of the surgically-excised piece and intra- or post-operatory complications were evaluated and evolution was followed-up for at least 30 days after surgery. Results: 854 patients were operated on during the observation period. Post-operatory follow-up was less than a month for 106 patients; the data presented here deals with the remaining 748 patients. The patients’ average age was 44 years (± 6.6); uterine myomatosis and adenomyosis were the main indications for LH. Average time spent in surgery was 90 minutes (± 17.7). Average uterine weight was 205 grams (± 88.3). Complications occurred in 41 patients (5.6%), six of which were serious complications (0.8%): three vesical lesions (0.4%), a urethral lesion (0.13%), one (0.13%) patient required operative laparoscopy due to bleeding after surgery and one (0.13%) patient underwent exploratory laparotomy because of abdominal pain. There was a 2% conversion to laparotomy rate. Conclusion: Using UM-VH has led to similar complication rates to those reported by other authors.

Keywords : Laparoscopic hysterectomy; total laparoscopic hysterectomy; uterine manipulator; complicacions.

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