[Laparoscopic hysterectomy as first-line procedure in the treatment of women with benign uterine pathology].
BACKGROUND
It is estimated that a total of 600,000 abdominal hysterectomies, vaginal and laparoscopic there are performed in USA, these figures make the hysterectomy the first ranked surgery. In our country, since the first description of the technique in 1989, laparoscopic hysterectomy (HL) has developed and evolved. However, the learning curve for mastering this procedure results in larger and more complex complications than other approaches.


METHODS
Retrospective, longitudinal and descriptive study were carried out, the collection of data took place from the clinical records of patients who underwent total laparoscopic hysterectomy during January 1, 2007 through December 31 of the same year. It was performed in women older than 18 years with benign uterine pathology. Body mass index greater than 30 Kg/m2, uterus greater than 16 weeks of gestational age or more than 500 grams, illnesses than compromise life of patients o women that did not return to post-surgical evaluation were excluded.


RESULTS
There were performe 75 laparoscopic hysterectonies, 72 underwent without any complication. The average hospital stay was 3 days. We founded 3 major surgical complications, a case of bleeding from the surgical area that was immediately attended by laparoscopic Vicril-00 single stitching. Also were founded 2 urinary lesions: 1 complex lesion of the trigonous. The follow up of this case was torpid it were needed to derivate for 15 day with a latex foley catheter after the secondary repair and was unsuccessfully. Thereafter a urogynecological team programed laparotomy for the final fistulectomy. And the third case of accident was referred to a ureteral section, was diagnosed by the leaking at opaquedye from the abdominal x ray, and the patient was programed to laparotomy to performed a termino-terminal anastomosis.


CONCLUSIONS
Laparoscopic hysterectomy is a reliable treatment option for benign uterine pathology. We believe that this surgical technique should be offered as the regular way to perform the hysterectomy.
Dirección General de los Servicios de Salud de Oaxaca. fidiasnoguera@yahoo.com.mx
Marcelo
M
Fidias Noguera-Sánchez
Jesús Carlos
JC
Briones-Garduño
Cesar Esli
CE
Rabadán-Martínez
Pedro
P
Antonio-Sánchez
Esperanza Josefina
EJ
Bautista-Gómez
José Manuel
JM
Ceja-Sánchez
D000328:Adult; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000379:methods*; D010535:Laparoscopy; D008137:Longitudinal Studies; D008875:Middle Aged; D012189:Retrospective Studies; D014591:Uterine Diseases / Q000601:surgery*