title: A review of the technique and complications from 2,012 cases of laparoscopically assisted vaginal hysterectomy at a single institution.
abstract: OBJECTIVE
  To present our experience of modified laparoscopically assisted vaginal hysterectomy (LAVH) and to evaluate the surgical outcomes and complications.
  
  
  METHODS
  Women with benign gynaecologic tumours that underwent a modified LAVH at the Samsung Medical Centre were analysed retrospectively. The technique is primarily a vaginal hysterectomy with a minor component of the laparoscopic procedures (stage 2 laparoscopic hysterectomy (LH)) and had two modifications (vaginal anterior colpotomy and McCall culdoplasty) from the standard technique.
  
  
  RESULTS
  A total of 2012 LAVH procedures were performed from January 2000 to May 2008. The mean duration of the operations and the uterine weight were 102±32 min and 305±168 g, respectively. In 196 (9.7%) cases, the uterine weight was more than 500 g. Conversion to laparotomy was needed in 97 cases. Major intraoperative complications occurred in 45 cases (2.2%): bladder injury, 26 (1.29%); bowel injury, nine (0.45%); haemorrhage of major vessels, nine (0.45%); and ureteral injury, one (0.05%). Major long-term complications occurred in three cases: one fistula and two trocar site herniations.
  
  
  CONCLUSIONS
  Stage 2 LH combined with modified vaginal anterior colpotomy and modified McCall culdoplasty is safe and effective for benign gynaecologic tumours and the prevention of post-LAVH vaginal prolapse.
authors.affiliation: Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-Dong, Gangnam-gu, Seoul, Korea.
authors.forename: Taejong
authors.initials: T
authors.lastname: Song
authors.forename: Tae-Joong
authors.initials: TJ
authors.lastname: Kim
authors.forename: Heeseok
authors.initials: H
authors.lastname: Kang
authors.forename: Yoo-Young
authors.initials: YY
authors.lastname: Lee
authors.forename: Chel Hun
authors.initials: CH
authors.lastname: Choi
authors.forename: Jeong-Won
authors.initials: JW
authors.lastname: Lee
authors.forename: Byoung-Gie
authors.initials: BG
authors.lastname: Kim
authors.forename: Duk-Soo
authors.initials: DS
authors.lastname: Bae
mesh_terms: D000328:Adult; D003106:Colon / Q000293:injuries; D005260:Female; D006470:Hemorrhage / Q000209:etiology; D006801:Humans; D007045:Hysterectomy, Vaginal / Q000009:adverse effects* / Q000379:methods* / Q000706:statistics & numerical data; D007431:Intraoperative Complications / Q000453:epidemiology*; D010535:Laparoscopy / Q000009:adverse effects* / Q000379:methods* / Q000706:statistics & numerical data; D007813:Laparotomy / Q000009:adverse effects / Q000706:statistics & numerical data; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology*; D012189:Retrospective Studies; D013525:Surgical Instruments / Q000009:adverse effects; D014521:Urethra / Q000293:injuries; D001743:Urinary Bladder / Q000293:injuries; D014596:Uterine Prolapse / Q000517:prevention & control; D014719:Vesicovaginal Fistula / Q000209:etiology