title: Feasibility and safety of total laparoscopic hysterectomy (TLH) using the Hohl instrument in nonobese and obese women.
abstract: OBJECTIVE
  The aim of the present study was to evaluate the feasibility, safety, and complication rates of total laparoscopic hysterectomy (TLH) using the Hohl instrument in nonobese and obese women.
  
  
  METHODS
  A prospective controlled trail (Canadian Task Force classification II-1) was conducted at the Department of Obstetrics and Gynecology, Erlangen University Hospital, Erlangen-Nuremberg, Germany. Two hundred and fifty-seven women underwent total laparoscopic hysterectomy using the Hohl instrument between January 2006 and May 2008. The laparoscopic approach was used when the patient had undergone previous pelvic abdominal operation and/or had a reduced vaginal capacity. Women were classified according to their body mass index (BMI), with a cutoff point of 30 kg/m(2). Total laparoscopic hysterectomy was performed using the Hohl instrument.
  
  
  RESULTS
  One ureteral injury, one bladder injury, one vaginal injury, and one injury to the epigastric vessels occurred. Blood transfusion was necessary in one patient. One conversion to abdominal hysterectomy was performed in a woman with a uterus weighing 893 g. In the postoperative phase, suture dehiscence at the vaginal closure occurred in three patients, one patient had bladder infection, one woman developed unexplained fever, and a hematoma without infection at the vaginal vault occurred in one woman. All complications occurred in women with BMI < 30 kg/m(2).
  
  
  CONCLUSIONS
  TLH using the Hohl instrument is feasible and safe in nonobese and obese patients.
authors.affiliation: Department of Obstetrics and Gynecology, Erlangen University Hospital, University of Erlangen-Nuremberg, Erlangen, Germany. andreas.mueller@uk-erlangen.de
authors.forename: Andreas
authors.initials: A
authors.lastname: Mueller
authors.forename: Falk
authors.initials: F
authors.lastname: Thiel
authors.forename: Johannes
authors.initials: J
authors.lastname: Lermann
authors.forename: Peter
authors.initials: P
authors.lastname: Oppelt
authors.forename: Matthias W
authors.initials: MW
authors.lastname: Beckmann
authors.forename: Stefan P
authors.initials: SP
authors.lastname: Renner
mesh_terms: D000328:Adult; D015992:Body Mass Index; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000295:instrumentation* / Q000379:methods*; D007431:Intraoperative Complications; D020706:Laparoscopes; D010535:Laparoscopy / Q000009:adverse effects; D008875:Middle Aged; D009765:Obesity; D011183:Postoperative Complications