Puntambekar S P, Wagh G N, Puntambekar S S, Sathe R M, Kulkarni M A, Kashyap M A, Patil A M, Ivo Meinhold-Heerlein
Galaxy Laparoscopy Institute, Pune, India;
Int J Biomed Sci. 2008 Mar;4(1):38-43.
Hysterectomy is one of the most commonly performed gynecological procedures. Although the first laparoscopic hysterectomy was performed in 1989, this technique accounts for only a few of all hysterectomies performed today. To assess the safety of total laparoscopic hysterectomy through a novel technique that we have evolved, a retrospective analysis of 140 patients with benign uterine pathologies operated at our institute between 2004 and 2007 was performed. All patients underwent total laparoscopic hysterectomy (TLH) using a simple technique. The highlight of this technique was the omission of any vaginal manipulator. The mean operation time was 88.75 ± 52.72 minutes, the mean blood loss 53.80 ± 35.94 ml and the mean hospital stay 2.21 ± 1.12 days. No conversion to open surgery was necessary. Iatrogenic complications were bowel injury (n=1) and vaginal tears (n=3) and were managed laparoscopically. The new method of TLH proved to be reproducible and safe with decreased morbidity and operation time. This can be attributed to the performance of the same standardized steps each time. Our technique provides a safe procedure suitable for routine use in gynecological surgery.
子宫切除术是最常施行的妇科手术之一。尽管首例腹腔镜子宫切除术于1989年实施，但在如今所有的子宫切除术中，这项技术所占比例仅为少数。为了通过我们改进的一项新技术评估全腹腔镜子宫切除术的安全性，我们对2004年至2007年间在我院接受手术的140例患有良性子宫病变的患者进行了回顾性分析。所有患者均采用一种简单的技术接受了全腹腔镜子宫切除术（TLH）。该技术的亮点是省去了任何阴道操作器械。平均手术时间为88.75±52.72分钟，平均失血量为53.80±35.94毫升，平均住院时间为2.21±1.12天。无需转为开腹手术。医源性并发症为肠损伤（n = 1）和阴道撕裂（n = 3），均通过腹腔镜进行了处理。新的全腹腔镜子宫切除术方法经证明具有可重复性且安全，发病率和手术时间均有所降低。这可归因于每次都执行相同的标准化步骤。我们的技术提供了一种安全的手术方法，适用于妇科手术的常规应用。
