Laparoscopic hysterectomy with retroperitoneal uterine artery sealing using LigaSure: Gazi hospital experience.
OBJECTIVE
The aim of this study was to evaluate the efficacy and safety of laparoscopic hysterectomy by retroperitoneal sealing of the uterine arteries with LigaSure.


METHODS
Laparoscopic hysterectomy by retroperitoneal uterine artery sealing with LigaSure was performed by four-puncture laparoscopy in 50 women with various indications for hysterectomy. The mean operation time, amount of intraoperative bleeding, drop in hemoglobin concentration, weight of removed uterus, major and minor per-post operative complications, and the rate of conversion to classical abdominal approach were analyzed prospectively.


RESULTS
The mean operation time was 85 min (range 60-125 min). The mean weight of removed uterus was 180 g (range 60-650 g). There was one major complication; one patient had cystotomy due to difficulty in dissecting severe adhesions because of two previous cesarean sections that were repaired laparoscopically. Only one patient converted to laparotomy because of severe bowel adhesions due to rectovaginal endometriosis. All patients were discharged on the first postoperative day. No minor complications occurred. Hemoglobin decreased a mean of 0.4 g/dl (range 0.2-1.4 g/dl) by postoperative day 1.


CONCLUSIONS
Laparoscopic hysterectomy by retroperitoneal uterine artery sealing with LigaSure is an effective, safe, and fast procedure with less intra operative bleeding, short operation time and hospital stay.
Gol
Mert
M
Department of Obstetrics and Gynecology, Gazi Hospital, 1421 str, Kahramanlar, Izmir, Turkey. drgyno@hotmail.com
Kizilyar
Aysen
A
Eminoglu
Mustafa
M
D000328:Adult; D000368:Aged; D001158:Arteries / Q000601:surgery; D016063:Blood Loss, Surgical; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000379:methods*; D007431:Intraoperative Complications; D010535:Laparoscopy / Q000379:methods*; D008026:Ligation / Q000379:methods; D008875:Middle Aged; D012187:Retroperitoneal Space; D013997:Time Factors; D016896:Treatment Outcome; D014599:Uterus / Q000098:blood supply*