Journal of minimally invasive gynecology
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J Minim Invasive Gynecol · Jan 2005
Comparative StudyLaparoscopic hysterectomy: the Kaiser Permanente San Diego experience.
To evaluate patient and surgical characteristics of laparoscopic hysterectomy (LH), including both total laparoscopic hysterectomy (TLH) and laparoscopic supracervical hysterectomy (LSH), compared with total abdominal hysterectomy (TAH). ⋯ Laparoscopic hysterectomy, both total and supracervical, can be successfully integrated into a large health maintenance organization/residency-training program. Laparoscopic hysterectomy took significantly longer to perform than TAH in this new program. Estimated blood loss was significantly less with LH than with TAH. Hospital length of stay was significantly less with LH than TAH. Major complications with TLH, minor complications with LH, overall complications, wound infections, urinary tract infections, and readmissions appear comparable with these parameters in TAH within the limits of our study size and design. Pelvic cellulitis was significantly more common with LH, and wound abscess was significantly more common with TAH. Major complications were significantly less common with LSH compared with combined TLH and TAH. Same-day discharge after LH seems to be an attractive option worth developing further. Our patients have enthusiastically accepted these new minimally invasive techniques for performing hysterectomy. We anticipate continued expansion of our LH program.
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J Minim Invasive Gynecol · Jan 2005
Randomized Controlled Trial Clinical TrialAn assessment of the value of rectus sheath block for postlaparoscopic pain in gynecologic surgery.
To compare the effect of the bilateral rectus sheath block (BRSB) by bupivacaine in decreasing postlaparoscopic pain with the intraperitoneal (IP) and intraincisional (II) use of this drug. ⋯ Bilateral rectus sheath block can effectively decrease postlaparoscopic pain at 6 and 10 hours after the operation when compared with IP and II use of bupivacaine.