Laparoscopically assisted vaginal hysterectomy for women with anterior wall adherence after cesarean section.
OBJECTIVE
To share and report experiences of using lateral approach technique to perform laparoscopically assisted vaginal hysterectomy (LAVH) for women with anterior wall adherence after cesarean section.


METHODS
We analyzed a retrospective chart review of 47 women with anterior wall adhesion after a cesarean section who underwent LAVH from March 1st 2003 to March 31st 2012, selected from a total of 1967 women who underwent LAVH during that period.


RESULTS
The median age of the patients was 42 years (range 34-56 years). The median operating time was 120 minutes (range 85-240 minutes), and the median weight of the removed uterus was 247 g (range 50-896 g). The median change in hemoglobin level was 2.0 g/dL (range 0-3.0 g/dL). The median hospital stay was 3.0 days (range 2-6 days). There were complications in 2 cases: bladder injury in one and postoperative ileus in the other. There were no conversions to laparotomy.


CONCLUSIONS
Lateral approach technique to make a pneumoperitoneum and to perform adhesiolysis is effective in LAVH for women with anterior wall adherence after cesarean section.
Department of Obstetrics and Gynecology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Sue Yeon
SY
Park
Department of Obstetrics and Gynecology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Jung Hun
JH
Lee
Department of Obstetrics and Gynecology, Hanyang University College of Medicine, Seoul, Republic of Korea.
Joong Sub
JS
Choi
Department of Obstetrics and Gynecology, Hanyang University College of Medicine, Seoul, Republic of Korea.
Jaeman
J
Bae
Department of Obstetrics and Gynecology, Hanyang University College of Medicine, Seoul, Republic of Korea.
Won Moo
WM
Lee
Department of Obstetrics and Gynecology, Hanyang University College of Medicine, Seoul, Republic of Korea.
Jung Hwa
JH
Ko
Department of Obstetrics and Gynecology, Hanyang University College of Medicine, Seoul, Republic of Korea.
A Ra
AR
Koh
Park's Ob & Gyn Clinics, Seoul, Republic of Korea.
Seon Hye
SH
Park
D000328:Adult; D002585:Cesarean Section / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007045:Hysterectomy, Vaginal / Q000379:methods*; D010535:Laparoscopy / Q000379:methods*; D008875:Middle Aged; D061646:Operative Time; D011247:Pregnancy; D012086:Reoperation; D012189:Retrospective Studies; D000267:Tissue Adhesions / Q000209:etiology / Q000601:surgery*
Adhesion; Cesarean section; Hysterectomy; Laparoscopic surgery