Laparoscopic Doderlein hysterectomy: a rational alternative to traditional abdominal hysterectomy.

Nearly three of four hysterectomies are performed by abdominal incision. When laparoscopically directed dissection of the uterus adnexae and development of the bladder flap are coupled with a Doderlein vaginal hysterectomy, most of these abdominal procedures can be converted to vaginal procedures. Experience with 167 procedures has demonstrated that this new procedure can be performed safely, effectively, and efficiently. The benefits of less postoperative discomfort, resulting in shorter hospital stays and quicker return to normal activity, coupled with a reduced cosmetic defect, have been clearly demonstrated.