Laparoscopic-assisted vaginal hysterectomy in a patient with placenta percreta.
Placenta percreta is a problem encountered with increasing frequency due to the rising rate of cesarean delivery. Conservative management of this condition is associated with decreased perioperative morbidity. When hysterectomy is necessary, a laparoscopic approach can provide additional  benefits. We present the case of a woman with placenta percreta with bladder invasion who was undergoing conservative management and then required delayed hysterectomy. Laparoscopic-assisted vaginal hysterectomy was successfully performed. We review the techniques used to ensure a good outcome  and the advantages of a minimally invasive approach to hysterectomy in this patient with placenta percreta.
Division of Minimally Invasive Gynecologic Surgery, Department of Obstetrics and Gynecology, Indiana University School of Medicine, Indianapolis, IN 46202, USA.
Bethany D
BD
Skinner
Alan M
AM
Golichowski
Gregory J
GJ
Raff
D000328:Adult; D005260:Female; D006801:Humans; D007045:Hysterectomy, Vaginal / Q000379:methods*; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay; D010921:Placenta Accreta / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D011247:Pregnancy; D016216:Ultrasonography, Prenatal; D001743:Urinary Bladder / Q000473:pathology