The value of intra-operative cystoscopy at the time of laparoscopic hysterectomy.
The aim of this study was to determine the usefulness of routine intra-operative cystoscopy in documenting ureteral injury during total laparoscopic hysterectomy with vault suspension and to document the incidence of this complication in a large series. The charts of 118 patients who underwent laparoscopic hysterectomy with vault suspension from January 1992 to January 1998 were retrospectively reviewed. The patients underwent intra-operative cystoscopic evaluation to verify ureteral permeability and bladder integrity. Intra-operative ureteral obstruction occurred in four patients (3.4%). All complications were immediately fixed and there were no postoperative ureteral problems. No late ureteral complications were observed. Intra-operative cystoscopy allows for early recognition and treatment of obstructive ureteral injuries and may reduce the rate of late postoperative complications during advanced laparoscopic procedures.
Division of Advanced Laparoscopic Surgery Division of Reproductive Endocrinology, Columbia Presbyterian Medical Center Columbia University College of Physicians and Surgeons, New York, New York, USA Hospital das Clinicas da FMUSP, Rua Eneas.
S
S
Ribeiro
H
H
Reich
J
J
Rosenberg
E
E
Guglielminetti
A
A
Vidali
D003558:Cystoscopy; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects* / Q000379:methods*; D007431:Intraoperative Complications / Q000175:diagnosis* / Q000601:surgery; D010535:Laparoscopy / Q000009:adverse effects; D011183:Postoperative Complications / Q000517:prevention & control; D012189:Retrospective Studies; D014513:Ureter / Q000293:injuries*; D014517:Ureteral Obstruction / Q000175:diagnosis / Q000209:etiology / Q000601:surgery