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Early outcomes of total LAVH versus supracervical LAVH
Selected Scientific Abstracts
Porcine Laparoscopy Training for Gynecologists and General Surgeons
that the laparoscopic Burch operation is a cost-effective method for treating women with stress incontinence.
DS Lasley, SR Seth, MK Yancey. Tripler Army Medical Center, Hawaii.
Early Outcomes of Total LAVH versus Supracervical LAVH
A porcine model was developed by the departments of general surgery and obstetrics and gynecology at Tripler Army Medical Center to teach the departments' residents and staff in diagnostic and therapeutic laparoscopy. Several laparoscopic procedures are performed per animal, and when these are completed, laparotomy is performed to practice open stapling techniques. The use of diagnostic and therapeutic laparoscopy has skyrocketed in the last 4 to 5 years. With this increase have come new laparoscopic instruments with which most staff and resident surgeons have had minimal experience. Rather than learning their use on human subjects, it is appropriate and necessary to provide a living model for periodic training sessions. The resultant familiarity with these instruments and tecbaaiques can shorten the learning curve and increase safety among human patients.
CJ Lalonde, JF Daniell. Centennial Medical Center, Nashville, TN.
Certain patients can benefit from subtotal laparoscopic hysterectomy, but this has not been evaluated in any great detail. We reviewed the charts of 40 patients undergoing laparoscopic hysterectomy, 20 subtotal and 20 total procedures. Questionnaires were also sent to assess postoperative recovery. The focus was on operating times, blood loss, hospital stay, complications, and total hospital costs to the patients. The results are shown in the table. Our early data suggest that in selected women, subtotal laparoscopic hysterectomy is associated with fewer complications, less blood loss, a shorter hospital stay, and less total cost to patients than laparoscopic hysterectomy. Average Average Estimated Average Average Time to Operating Blood Hospital Time to Full Time Loss Stay Intercourse Activity Procedure (hrs:min) (ml) (days) (wks) (wks)
Advantages of Laparoscopic Supracervical Hysterectomy CN Lee, JW Kim, MC Shin. International Clinic, CHA Women's Hospital, Seoul, Korea.
Complications
Total LAVH
2:04
247
1.7
5.9
3.5
3
Subtotal LAVH
1:46
200
1. l
3.5
3.3
0
From October 1992 to February 1995 we performed 214 modified classic intrafascial supracervical hysterectomies (CISH) and 1167 total abdominal hysterectomies. After 2 years we compared the procedures with respect to operating time, length of hospital stay, complications, and cost. We conclude that laparoscopic modified CISH is an excellent alternative to total abdominal hysterectomy and laparoscopicassisted vaginal hysterectomy.
Impact of Laparoscopic-AssistedVaginal Hysterectomy on Total Abdominal Hysterectomy and Total Vaginal Hysterectomy C Lall. Department of Obstetrics and Gynecology, Wayne State University, Detroit, MI.
Comparative and Feasibility Study of LaparoscopicAssisted Hysterectomy versus Total Abdominal Hysterectomy
This study was undertaken to evaluate changing trends of hysterectomies after the advent of laparoscopic-assisted vaginal hysterectomy (LAVH). A review of 250 hysterectomies performed from 1992 to 1994 showed that the number of abdominal hysterectomies decreased from 80% to 30% and the number of vaginal hysterectomies more than doubled. The major impact of LAVH may be the increase in the number of vaginal hysterectomies.
Pl Lee. Department of Gynecologic Endoscopy, Jeil Women's Hospital, Seoul, Korea.
We assessed the feasibility of converting total abdominal hysterectomy (TAH) to laparoscopicassisted hysterectomy (LAH) and identified differences in the postoperative outcome of women undergoing the procedures. All 170 women undergoing hysterectomy during 1994 were evaluated. Three
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Porcine Laparoscopy Training for Gynecologists and General Surgeons
that the laparoscopic Burch operation is a cost-effective method for treating women with stress incontinence.
DS Lasley, SR Seth, MK Yancey. Tripler Army Medical Center, Hawaii.
Early Outcomes of Total LAVH versus Supracervical LAVH
A porcine model was developed by the departments of general surgery and obstetrics and gynecology at Tripler Army Medical Center to teach the departments' residents and staff in diagnostic and therapeutic laparoscopy. Several laparoscopic procedures are performed per animal, and when these are completed, laparotomy is performed to practice open stapling techniques. The use of diagnostic and therapeutic laparoscopy has skyrocketed in the last 4 to 5 years. With this increase have come new laparoscopic instruments with which most staff and resident surgeons have had minimal experience. Rather than learning their use on human subjects, it is appropriate and necessary to provide a living model for periodic training sessions. The resultant familiarity with these instruments and tecbaaiques can shorten the learning curve and increase safety among human patients.
CJ Lalonde, JF Daniell. Centennial Medical Center, Nashville, TN.
Certain patients can benefit from subtotal laparoscopic hysterectomy, but this has not been evaluated in any great detail. We reviewed the charts of 40 patients undergoing laparoscopic hysterectomy, 20 subtotal and 20 total procedures. Questionnaires were also sent to assess postoperative recovery. The focus was on operating times, blood loss, hospital stay, complications, and total hospital costs to the patients. The results are shown in the table. Our early data suggest that in selected women, subtotal laparoscopic hysterectomy is associated with fewer complications, less blood loss, a shorter hospital stay, and less total cost to patients than laparoscopic hysterectomy. Average Average Estimated Average Average Time to Operating Blood Hospital Time to Full Time Loss Stay Intercourse Activity Procedure (hrs:min) (ml) (days) (wks) (wks)
Advantages of Laparoscopic Supracervical Hysterectomy CN Lee, JW Kim, MC Shin. International Clinic, CHA Women's Hospital, Seoul, Korea.
Complications
Total LAVH
2:04
247
1.7
5.9
3.5
3
Subtotal LAVH
1:46
200
1. l
3.5
3.3
0
From October 1992 to February 1995 we performed 214 modified classic intrafascial supracervical hysterectomies (CISH) and 1167 total abdominal hysterectomies. After 2 years we compared the procedures with respect to operating time, length of hospital stay, complications, and cost. We conclude that laparoscopic modified CISH is an excellent alternative to total abdominal hysterectomy and laparoscopicassisted vaginal hysterectomy.
Impact of Laparoscopic-AssistedVaginal Hysterectomy on Total Abdominal Hysterectomy and Total Vaginal Hysterectomy C Lall. Department of Obstetrics and Gynecology, Wayne State University, Detroit, MI.
Comparative and Feasibility Study of LaparoscopicAssisted Hysterectomy versus Total Abdominal Hysterectomy
This study was undertaken to evaluate changing trends of hysterectomies after the advent of laparoscopic-assisted vaginal hysterectomy (LAVH). A review of 250 hysterectomies performed from 1992 to 1994 showed that the number of abdominal hysterectomies decreased from 80% to 30% and the number of vaginal hysterectomies more than doubled. The major impact of LAVH may be the increase in the number of vaginal hysterectomies.
Pl Lee. Department of Gynecologic Endoscopy, Jeil Women's Hospital, Seoul, Korea.
We assessed the feasibility of converting total abdominal hysterectomy (TAH) to laparoscopicassisted hysterectomy (LAH) and identified differences in the postoperative outcome of women undergoing the procedures. All 170 women undergoing hysterectomy during 1994 were evaluated. Three
$24