Laparoscopic subtotal hysterectomy using the plasma kinetic and lap loop systems: an alternative approach in the surgical management of women with uterine fibroids.
OBJECTIVE
To evaluate the safety and applicability of laparoscopic subtotal hysterectomy (LSH) using the plasma kinetic (PK) and lap loop systems as an alternative surgical approach in the management of uterine fibroids in women who have completed their families.


METHODS
Sixty-two consecutive LSH were performed during this prospective study from March 2003 to March 2005 at Princess Royal University Hospital, Kent, UK.


RESULTS
All study patients had menorrhagia resistant to at least one form of therapy, with a mean duration of symptoms of 3.5 years. In addition, four patients had previous myomectomy. The mean number of fibroids removed was 2.7. The mean weight of the uterus was 141.9 g. The mean operative time was 46.8 min, and the mean blood loss was 126.6 mL. The overall perioperative complication rate was 4.8% with no visceral injury, or return to theatre. At follow-up, all patients were satisfied with surgery.


CONCLUSIONS
The study describes the first application of the PK and Lap Loop systems in LSH for the surgical management of uterine fibroids in women in whom fertility is not an issue, and its findings suggest that this minimally invasive technique is a safe, and valid alternative. Larger adequately-powered studies are however still required.
Erian
John
J
Minimal Access Surgery Unit, Department of Obstetrics and Gynaecology, Princess Royal University Hospital, Orpington, Kent BR6 8ND, United Kingdom.
El-Shawarby
Salem A
SA
Hassan
Mohsen
M
Wissa
Ihab
I
Chandakas
Stefanos
S
Hill
Nicholas
N
D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D007889:Leiomyoma / Q000601:surgery*; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods; D017063:Outcome Assessment, Health Care; D017060:Patient Satisfaction; D011446:Prospective Studies; D014594:Uterine Neoplasms / Q000601:surgery*