Laparoscopic hysterectomy. Supracervical vs. assisted vaginal.

Twenty cases of laparoscopic supracervical hysterectomy performed by operative laparoscopy without vaginal assistance were retrospectively compared to 232 cases of laparoscopically assisted vaginal hysterectomy reported in the literature. The specimens were morcellated intraabdominally and removed through the umbilicus. This is the first reported series of this technique with intraabdominal morcellation, which emphasizes cosmetic considerations and remains within the confines of the umbilicus. The postoperative hospitalization time ranged from 3.75 to 22.2 hours. On the second postoperative day, 10% of the patients returned to work, and 15% were able to drive. Patients resumed normal activity in an average of 5.6 days after surgery. As compared to laparoscopically assisted vaginal hysterectomy, there was a decrease in morbidity, blood loss and recovery time. Prolonged anesthesia from the longer operating time was clinically insignificant in terms of the patients' recovery. By decreasing the disability from hysterectomy from six weeks to one, the procedure provided financial savings through work time gained.