A simple procedure for the prevention of ureteral injury in laparoscopic-assisted vaginal hysterectomy.
OBJECTIVE
To introduce a surgical technique to minimize the chance of ureteral injury during laparoscopic-assisted vaginal hysterectomy (LAVH).


METHODS
Retrospective case review (Canadian Task Force classification II-3).


METHODS
Show Chwan Memorial Hospital, Changhua, Taiwan.


METHODS
Two thousand and six women who underwent LAVH between January 1992 and June 2001.


METHODS
A simple step of creating a "window" over the anterior and posterior broad ligaments to push inferolaterally the areolar tissue (in which the ureter is embedded) on the posterior broad ligament.


RESULTS
No ureteral injury occurred in patients whose cases were reviewed. There were, however, five bladder injuries (0.25%) and three nerve pareses (0.15%). Other minor complications, including fever, abscess or hematoma of the vaginal cuff, subcutaneous emphysema, and delayed vaginal cuff bleeding, occurred in less than 5% of patients.


CONCLUSIONS
The technique proposed is simple and very effective in preventing ureteral injury during LAVH.
Koh
Lim-Woh
LW
Department of Obstetrics and Gynecology, Show Chwan Memorial Hospital, Changhua, Taiwan.
Koh
Pui-Hon
PH
Lin
Li-Chuan
LC
Ng
Weenee Jao Yeun
WJ
Wong
Eric
E
Huang
Min-Ho
MH
D000328:Adult; D000368:Aged; D001956:Broad Ligament; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007045:Hysterectomy, Vaginal / Q000009:adverse effects* / Q000379:methods; D015907:Hysteroscopy / Q000009:adverse effects / Q000379:methods; D007431:Intraoperative Complications / Q000517:prevention & control*; D010535:Laparoscopy / Q000009:adverse effects* / Q000379:methods*; D008875:Middle Aged; D012189:Retrospective Studies; D018570:Risk Assessment; D016896:Treatment Outcome; D014513:Ureter / Q000293:injuries*; D014515:Ureteral Diseases / Q000517:prevention & control