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KMID : 1134220080280020004
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Hanyang Medical Reviews
2008 Volume.28 No. 2 p.4 ~ p.16
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Update in Laparoscopic Hysterectomy and Laparoscopic Myomectomy
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Lee Il-han
Kim Jung-Yeon
Kim Dong-Ho
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Abstract
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The role of laparoscopic hysterectomy (LH) in current gynecological practice has yet to be defined. Randomized trials have demonstrated that, compared to abdominal hysterectomy, LH shortens hospital stay and induces less postoperative
pain and quicker recovery. Some retrospective publications it seems that complication rates have increased in LH, especially those involving the urinary system. However, a recent analysis revealed a reasonable complication rate for the
procedure, compared with abdominal hysterectomy, Laparoscopic supracervical hysterectomy (LSH) is a minimally invasive procedure that was developed during the 1990s as a treatment for abnormal uterine bleeding. The literature regarding this procedure, mainly case series and retrospective comparisons, suggests that LSH results in reduced operating time and blood loss and a quicker return to normal activity, compared with laparoscopic-assisted vaginal hysterectomy (LAVH). Given the lack of appropriate randomized, controlled trials and the limitations of the existing
research, the LSH’s true value and appropriate clinical indications remain unknown.
Uterine fibroids are the most common benign tumors of the uterus. Management depends on the symptoms, location and size of the fibroids, and the patient’s desire to conceive. Surgical management of uterine fibroids has changed from laparotomy to minimally invasive surgery. Advances in surgical instruments and techniques are expanding the role of laparoscopic myomectomy in well-selected individuals. Meticulous repair of the myometrium is essential for women considering pregnancy after laparoscopic myomectomy to minimize the risk of uterine rupture. Laparoscopic myomectomy is an appropriate alternative to abdominal myomectomy or hysterectomy.
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KEYWORD
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Laparoscopic hysterectomy, Laparoscopic supracervical hysterectomy, Laparoscopic myomectomy
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