title: [Analysis of 216 cases of total laparoscopic hysterectomy].
abstract: OBJECTIVE
  To investigate the effectiveness and safety of total laparoscopic hysterectomy (TLH).
  
  
  METHODS
  A retrospective study of laparoscopic hysterectomy was conducted in this setting. From March 2002 through March 2004, 216 women were subjected to TLH. The average age of the patients was 45.5 years (38-60 years). Out of the 216 patients, 24 had dysfunctional uterine bleeding, 5 atypical endometrial hyperplasia, 139 uterine fibroid, 46 adenomyosis, 2 cervical carcinoma in situ and 36 had a previous lower abdominal surgery. The TLH was carried out using ultrasonic scalpel and the amputated uterus was removed transvaginally. The vagina and peritoneum were closed under laparoscopy.
  
  
  RESULTS
  Of the 216 cases who underwent TLH, 23 had bilateral adnexectomy, 36 had ovarian cystectomy, and 54 had adhesiolysis simultaneously. No case was converted to laparotomy. The mean operating time was (103 +/- 35) min. The average amount of blood loss was 83 +/- 45 ml (60-320 ml) during operation. The average hospital stay after operation was (5.3 +/- 1.9) days. There were 4 patients with urinary tract injury in this study population. One bladder perforation was found during operation and repaired under laparoscopy. Two patients had vesicovaginal fistula formation. One ureteral-vaginal fistula was found after operation. The fistula was all closed spontaneously with a prolonged catheter drainage.
  
  
  CONCLUSIONS
  TLH appears a safe, effective and reproducible procedure. It is an alternative method for those women who need hysterotomy.
authors.affiliation: Department of Obstetrics and Gynecology, First Affiliated Hospital of Sun Yat-san University, Guangzhou 510080, China.
authors.forename: Shu-zhong
authors.initials: SZ
authors.lastname: Yao
authors.forename: Shu-qin
authors.initials: SQ
authors.lastname: Chen
authors.forename: Hong-zhe
authors.initials: HZ
authors.lastname: Xie
authors.forename: Gang
authors.initials: G
authors.lastname: Niu
authors.forename: Yu-qing
authors.initials: YQ
authors.lastname: Chen
authors.forename: Dong-qing
authors.initials: DQ
authors.lastname: Liu
authors.forename: Jian-zhao
authors.initials: JZ
authors.lastname: Huang
mesh_terms: D000328:Adult; D004714:Endometrial Hyperplasia / Q000601:surgery; D004715:Endometriosis / Q000601:surgery; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000379:methods*; D010535:Laparoscopy; D007902:Length of Stay; D008875:Middle Aged; D015203:Reproducibility of Results; D012189:Retrospective Studies; D014599:Uterus / Q000473:pathology / Q000601:surgery