[Total hysterectomy of laparoendoscopic single site surgery].

OBJECTIVE

To explore the operation skills of laparoendoscopic single site surgery (LESS) of total hysterectomy, to expand the application of LESS in the field of in gynecologic surgery.

METHODS

A total of 23 cases of total hysterectomy were completed under laparoendoscopic single site surgery in Peking Union Medical College Hospital from January 2012 to August 2013, applying with combination of the traditional laparoscopic and special LESS apparatuses, intelligent electronic coagulation and excision device and the self-fixed absorbable sutures (V-LOC). The datas of the patients during the operations and the follow-up were recorded and analyzed.

RESULTS

Twenty-three cases LESS-TH are accomplished. The weight of uterus was (230+38) g. The operation time was (73+22) minutes, with the intraoperative blood loss (99 ± 53) ml. The postoperative intestinal function recovery time was (13+4) hours, and postoperative hospitalized time was (1.8 ± 0.6) days, with the postoperative pain visual analogue scale 3.9 ± 1.6. There were no complications reported during intraoperative and postoperative time. All of our patients was finished the follow-up from 14 d to 2 months. As usual, vaginal discharge is normal, wound healed well, most of the wounds healing (19/23) hidden in umbillicus, no obvious scar, vaginal stub wound healed well.

CONCLUSIONS

(1) LESS can accomplish total hysterectomy of uterus of gestational age less than 8 weeks safely and effectively. (2) Combination of traditional laparoscopic and special LESS appatatuses, the use of intelligent energy devices and V- LOC to suture vaginal stub could make the total hysterectomy by LESS much easier and safer.