• C Anquetil, S Capella-Alouc, and H Fernandez.
• Service de Gynéco-Obstétrique, Hôpital Antoine Béclère.
• Contracept Fertil Sex. 1999 Apr 1; 27 (4): 291-7.

Study ObjectiveTo investigate the alternative routes for hysterectomy for benign disease and the appropriate role of laparoscopic surgery.DesignRetrospective study of hysterectomies performed between August 1991 and July 1997.SettingUniversity hospital.PatientsHysterectomy for benign disease without prolapse, pelvic floor relaxation.Intervention359 hysterectomies: vaginal (n = 211), laparoscopically-assisted vaginal (n = 56), and abdominal (n = 92).Measurements And Main ResultsUterine volume was the principal indication for laparotomy. Laparoscopy was required only in cases of adnexal disorders or when the vaginal access was limited or associated with extensive adhesions. The rate of laparotomies and laparoscopies dropped steadily over the six-year study period: during the last two years, 75% of all hysterectomies were vaginal, and 90% of those for patients without a previous vaginal birth.ConclusionWith experienced surgeons, the number of cases in which there appears to be poor vaginal accessibility experience decreases, and indications for vaginal hysterectomies increase.

18 keywords...

hide…