title: A simple procedure for the prevention of ureteral injury in laparoscopic-assisted vaginal hysterectomy.
abstract: 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.
authors.affiliation: Department of Obstetrics and Gynecology, Show Chwan Memorial Hospital, Changhua, Taiwan.
authors.forename: Lim-Woh
authors.initials: LW
authors.lastname: Koh
authors.forename: Pui-Hon
authors.initials: PH
authors.lastname: Koh
authors.forename: Li-Chuan
authors.initials: LC
authors.lastname: Lin
authors.forename: Weenee Jao Yeun
authors.initials: WJ
authors.lastname: Ng
authors.forename: Eric
authors.initials: E
authors.lastname: Wong
authors.forename: Min-Ho
authors.initials: MH
authors.lastname: Huang
mesh_terms: 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