title: Reverse hysterectomy: another technique for performing a laparoscopic hysterectomy.
abstract: OBJECTIVE
  To show and evaluate outcomes of a modified laparoscopic hysterectomy technique (total reverse laparoscopic hysterectomy).
  
  
  METHODS
  Observational study (Canadian Task Force classification II-2).
  
  
  METHODS
  Department of Women's and Children's Health, Obstetrics and Gynecology Clinic, University of Padova, Padova, Italy.
  
  
  METHODS
  One hundred one women underwent total reverse laparoscopic hysterectomy for benign disease. Indications for surgery, patient characteristics, surgical data, complications, and patient satisfaction were recorded.
  
  
  METHODS
  Total reverse laparoscopic hysterectomy.
  
  
  RESULTS
  The modified procedure was performed starting with the incision of the vesicouterine fold and the pubocervical fascia followed by the dissection of only the anterior layer of the broad ligament, thus preserving the integrity of the posterior leaf (retrograde hysterectomy). This technique permits identification of the ureter until the cross with the uterine artery, creating a "safe triangle" for closure of the uterine vessels. The remaining surgical time did not differ from the standard technique. The average operating time was 112.1 ± 35.6 minutes, and the average intraoperative mean blood loss was 79.5 ± 138.4 mL. Ninety-one (90%) patients were very satisfied after surgery. No injuries to the ureter or bladder occurred in any patients. No other major complications were recorded.
  
  
  CONCLUSIONS
  Reverse hysterectomy is another technique for performing laparoscopic hysterectomy, and it has been proven to be safe and efficient.
authors.affiliation: Department of Women's and Children's Health, Obstetrics and Gynecology Clinic, University of Padova, Padova, Italy.
authors.forename: Pietro
authors.initials: P
authors.lastname: Litta
authors.forename: Carlo
authors.initials: C
authors.lastname: Saccardi
authors.forename: Lorena
authors.initials: L
authors.lastname: Conte
authors.forename: Pasquale
authors.initials: P
authors.lastname: Florio
mesh_terms: D000328:Adult; D004714:Endometrial Hyperplasia / Q000601:surgery; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects / Q000379:methods*; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D008875:Middle Aged; D017060:Patient Satisfaction; D017699:Pelvic Pain / Q000601:surgery; D011183:Postoperative Complications / Q000209:etiology; D016896:Treatment Outcome; D014592:Uterine Hemorrhage / Q000601:surgery
keywords: Complications; Laparoscopic hysterectomy; Surgical technique