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Kang and Moon: Laparoscopically assisted vaginal hysterectomy using 3-trocar method through the previous operation scar for large uterus weighing 300 g or more
Original Article
Korean Journal of Obstetrics and Gynecology

Korean Journal of Obstetrics and Gynecology 2010; 53(10): 921-926.

Published online: 31 October 2010

DOI: https://doi.org/10.5468/kjog.2010.53.10.921

Laparoscopically assisted vaginal hysterectomy using 3-trocar method through the previous operation scar for large uterus weighing 300 g or more

Eun Ji Kang, M.D., Hye-Sung Moon, M.D.

Department of Obstetrics and Gynecology, Ewha Womans University School of Medicine, Seoul, Korea.

Corresponding author (mhsmhs@ewha.ac.kr)

Received 7 June 2010       Revised 27 July 2010       Accepted 6 September 2010

Copyright © 2010 Korean Society of Obstetrics and Gynecology

Abstract

Objective

The purpose of this study is to examine the feasibility and safety of laparoscopically assisted vaginal hysterectomy (LAVH) using 3-trocar method through the previous operation scar for uterus weighing 300 g or more in the management of gynecologic disease.

Methods

This retrospective study was peformed in 51 cases of LAVH with uterus weighing 300 g or more and with symptomatic benign gynecologic diseases (leiomyoma or adenomyosis). LAVH was performed through 3-trocar method (one trocar below the umbilicus, and two trocars at the point about 2 cm above and medial side of each anterior superior iliac spine, or at the bilateral edges of the previous operation scar).

Results

Previous operation history was found in 17 cases (33.3%) and cesarean section was the most common. There was no difference in the age, body mass index, parity, length of operation, amount of blood loss, hemoglobin change, length of gas out, and hospital stay, rate of transfusion and complication between two groups divided by history of operation (P>0.05). Uterine weight in the group having operation history was lighter than that in group having not operation history (519.91±220.53 g and 381.24±70.63 g, respectively, P<0.05).

Conclusion

LAVH for large uterus weighing 300 g or more using 3-trocar method through previous operation scar is safe and effective operation method, and may be an alternative to abdominal hysterectomy in selected patients.

Keywords: Laparoscopically assisted vaginal hysterectomy, Uteri weighing 300 g or more, Previous operation scar

Figures and Tables

Table 1
Previous operation history (Group 1)
kjog-53-921-i001

*3 out of 17 in group 1 had a double operation histories.

Table 2
Demographic characteristics of the study group
kjog-53-921-i002

Values are presented as Mean±standard deviation (SD).

BMI: body mass index, NS: not significant.

Table 3
Comparison of outcome variables in undergoing LAVH with or without pervious operation history
kjog-53-921-i003

Values are presented as Mean±standard deviation (SD).

LAVH: laparoscopically assisted vaginal hysterectomy, NS: not significant.

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