One hundred cases of laparoscopic subtotal hysterectomy using the PK and Lap Loop systems.
OBJECTIVE
To evaluate the safety and short-term outcomes of laparoscopic subtotal hysterectomy using the PK and Lap Loop systems.


METHODS
Prospective observational study (Canadian Task Force classification II-2).


METHODS
Princess Royal University and Chelsfield Park Hospitals, Kent, UK.


METHODS
One hundred women who underwent laparoscopic subtotal hysterectomy for menorrhagia from February 2003 through July 2004.


METHODS
The procedure was performed using the Plasma Kinetic (PK) system to seal the vascular pedicles and the Lap Loop system to separate the uterus at the level of the internal os. The uterus was removed from the abdominal cavity mainly by morcellation or posterior colpotomy.


RESULTS
Of 100 patients, 59 were operated on as outpatients. Mean patient age was 44.6 years, median parity was 2, mean body mass index was 26.8, and mean duration of symptoms was 4 years. Clinically, the uterus was enlarged in 70 patients, and preoperative ultrasound scanning suggested the presence of uterine myomas in 42 patients. In addition to hysterectomy, 47 patients had concomitant pelvic surgery. The mean total operating time was 45.5 minutes, and mean estimated blood loss was 114 mL. The overall major complication rate was 2%; two patients required blood transfusion after surgery. There were no bowel or urinary tract injuries, unintended laparotomy, return to operating room, or anesthetic complications. At follow-up, all patients were satisfied with surgery.


CONCLUSIONS
Laparoscopic subtotal hysterectomy using the PK and Lap Loop systems for treatment of therapy-resistant menorrhagia is safe, can be performed as an outpatient procedure, and is associated with reduced operating time and high patient satisfaction.
Erian
John
J
Gynecology Department, Princess Royal University Hospital, Orpington, Kent, United Kingdom. johnerian@aol.com
El-Toukhy
Tarek
T
Chandakas
Stefanos
S
Theodoridis
Theo
T
Hill
Nicholas
N
D000328:Adult; D004564:Electrocoagulation; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects / Q000379:methods*; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay; D008595:Menorrhagia / Q000601:surgery*; D017060:Patient Satisfaction; D011446:Prospective Studies