Small intestine injury in laparoscopic-assisted vaginal hysterectomy.
OBJECTIVE
To review laparoscopic-assisted vaginal hysterectomy (LAVH) cases for instances of small intestine injury.


METHODS
Retrospective review (Canadian Task Force Classification II-2).


METHODS
Tertiary care university hospital.


METHODS
Two thousand six hundred eighty-two women.


METHODS
LAVH.


RESULTS
Indications for hysterectomy were myomata uteri, adenomyosis, intractable menorrhagia, endometriosis, severe pelvic adhesions, cervical intraepithelial neoplasia, endometrial polyps, and hyperplasia. Small bowel injuries occurred in five women (1.9/1000), one (20%) of which was recognized postoperatively. Thermal injuries occurred in two patients, trocar injuries in two, and a dissection wound in one. Two-layer closure was performed for three patients, and partial resection with reanastomosis for two. All patients were discharged without sequelae.


CONCLUSIONS
Small bowel injury during LAVH is not common. It may have unusual characteristics and devastating consequences if not recognized and treated promptly.
Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Kaohsiung, Taiwan.
Chung-Chang
CC
Shen
Ming-Ping
MP
Wu
Cheng-Hsien
CH
Lu
Yu-Chiang
YC
Hung
Hao
H
Lin
Eng-Yen
EY
Huang
Fu-Jen
FJ
Huang
Te-Yao
TY
Hsu
Shiuh-Young
SY
Chang
D000328:Adult; D016889:Endometrial Neoplasms / Q000601:surgery; D004715:Endometriosis / Q000601:surgery; D005260:Female; D006801:Humans; D007045:Hysterectomy, Vaginal / Q000009:adverse effects* / Q000379:methods; D007421:Intestine, Small / Q000293:injuries*; D007431:Intraoperative Complications / Q000453:epidemiology*; D010535:Laparoscopy; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology*; D012189:Retrospective Studies; D000267:Tissue Adhesions / Q000601:surgery; D002583:Uterine Cervical Neoplasms / Q000601:surgery; D014594:Uterine Neoplasms / Q000601:surgery; D002578:Uterine Cervical Dysplasia / Q000601:surgery