Kriplani Alka, Garg Pradeep, Sharma Meenakshi, Lal Suman, Agarwal Nutan
Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, New Delhi, India.
J Laparoendosc Adv Surg Tech A. 2008 Dec;18(6):825-9. doi: 10.1089/lap.2008.0034.
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.
We conducted a retrospective review of cases who underwent TLH over 1.5 years.
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).
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%)].
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.
The mean age of the patients was 43.1 +/- 0.602 years and mean body mass index was 25.19 +/- 0.39 kg/m(2). 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.
Laparoscopic hysterectomy by uterine artery sealing with LigaSure is a safe, efficient procedure with a low complication rate.
本研究旨在评估使用Ligasure系统封闭子宫动脉进行全腹腔镜子宫切除术（TLH）的疗效和安全性。
我们对1.5年多来接受TLH的病例进行了回顾性研究。
本研究在印度新德里全印度医学科学研究所妇产科的三级医疗医院环境中进行。
共有110例因子宫病变接受TLH的患者[67例（60.9%）为子宫肌瘤，34例（30.9%）为功能性子宫出血，9例（8.1%）为其他情况]。
使用LigaSure系统（美国科罗拉多州博尔德市Valleylab公司）进行全腹腔镜子宫切除术，通过封闭子宫动脉并使用Prashant Mangeshikar子宫操纵器提升子宫。
患者的平均年龄为43.1±0.602岁，平均体重指数为25.19±0.39kg/m²。平均手术时间为116.91±3.4分钟，平均术中失血量为173.09±11.64mL，切除子宫的平均重量为224.14±17.62g。6例患者由腹腔镜手术转为开腹手术（4例因肌瘤较大，2例因粘连致密），1例转为腹腔镜辅助阴道子宫切除术（阴道袖口撕裂）。1例患者（0.9%）在术中发生肺气肿。术后并发症包括3例（2.7%）麻痹性肠梗阻、2例（1.8%）尿潴留和12例（10.9%）患者发热。无膀胱或肠道损伤。
使用Ligasure封闭子宫动脉进行腹腔镜子宫切除术是一种安全、有效的手术，并发症发生率低。
