Frequency and cause of aborted laparoscopic-assisted vaginal hysterectomy.
OBJECTIVE
To evaluate the frequency and cause of aborted laparoscopic-assisted vaginal hysterectomies (LAVH) at two hospitals of a major obstetrics and gynecology training program.


METHODS
Retrospective cohort study.


METHODS
A university hospital and a university-affiliated county hospital.


METHODS
Seventy-eight consecutive women who underwent LAVH at our institutions between June 1992 and February 1995.


METHODS
Data on age, weight, indications for surgery, obstetric and surgical history, concomitant procedures performed, postoperative diagnosis, perioperative complications, operative time, estimated blood loss, uterine weight, and length of hospital stay were collected from patients' hospital records. Univariate analysis of variance to assess statistical significance was performed when appropriate.


RESULTS
Eight (11.1%) of 78 procedures were converted to abdominal hysterectomy. The most frequent reason for conversion (5 cases, 6%) was large uterine size with limited mobility and associated inability to visualize the pelvic sidewall structures adequately. The other three procedures were converted because of massive intraperitoneal adhesions (2) and intraoperative severe bleeding (1). The mean uterine weight of these eight women (575 g, range 387-1030 g) was significantly higher than that of patients undergoing successful LAVH (230 g, range 35-612; p <0.03).


CONCLUSIONS
In our limited series of 78 patients, only one LAVH was converted to abdominal hysterectomy because of an intraoperative complication. A conversion rate of 11.1% may be appropriate so as to offer the potential benefits of the laparoscopic-assisted vaginal approach to the largest number of women who would otherwise undergo an abdominal hysterectomy.
Cristoforoni
P M
PM
Gynecologic Oncology Service, Department of Obstetrics and Gynecology, UCLA School of Medicine, CHS 24-127, 10833 Le Conte Avenue, Los Angeles, CA 90095-1740, USA.
Palmieri
A
A
Gerbaldo
D
D
Montz
F J
FJ
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000295:instrumentation / Q000379:methods; D007045:Hysterectomy, Vaginal / Q000295:instrumentation / Q000379:methods; D015994:Incidence; D007431:Intraoperative Complications / Q000453:epidemiology* / Q000209:etiology; D010535:Laparoscopy; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D014599:Uterus / Q000473:pathology / Q000503:physiopathology