Placenta percreta is a problem encountered with increasing frequency due to the rising rate of cesarean delivery. Conservative management of this condition is associated with decreased perioperative morbidity. When hysterectomy is necessary, a laparoscopic approach can provide additional benefits. We present the case of a woman with placenta percreta with bladder invasion who was undergoing co...

OBJECTIVE To investigate the risk of vaginal cuff dehiscence after different routes of hysterectomy and methods of cuff closure. METHODS A multi-institutional analysis of 12,398 patients who underwent hysterectomy for both benign and malignant disease between 1994 and 2008 was performed. We analyzed how different routes of hysterectomy and approaches to cuff suture may influence the risk of d...

OBJECTIVE The purpose of this study was to evaluate risk factors of vaginal cuff dehiscence or evisceration according to the type of operation. METHODS Medical records of 604 women who underwent hysterectomies at Korea University Anam Hospital between June 2007 and June 2011 were reviewed. They were allocated to six groups. The six types of hysterectomies included robotic hysterectomy (n = 7)...

BACKGROUND AND OBJECTIVES To evaluate the feasibility of a minimally invasive approach for hysterectomy for benign disease at a university teaching hospital. METHODS Five hundred thirty-seven consecutive patients underwent hysterectomy for benign disease at Penn State Milton S. Hershey Medical Center in 2010. No cases were excluded. Minimally invasive approaches included total vaginal hystere...

The final decision to perform a certain method of hysterectomy customarily mirrors experience and level of comfort with a particular surgical approach in the context of the patient's condition and indication for surgery. Given the morbidity and recovery associated with a laparotomic incision, every effort should be made to avoid abdominal hysterectomy. The best available evidence points to the ...

OBJECTIVE To assess the standard of hysterectomy in public hospitals in Hong Kong, so as to improve the quality of patient care and outcome. DESIGN Clinical audit. SETTING Twelve Hong Kong Hospital Authority public hospitals. PATIENTS All patients undergoing hysterectomy for benign gynaecological conditions during the period from 1 July 2002 to 31 December 2002 inclusive. RESULTS A tota...

BACKGROUND Many hysterectomies are now performed by a laparoscopically assisted vaginal technique. This procedure is controversial, partly because of concern about cost. We studied hospital charges and costs for the procedure as compared with those for total abdominal hysterectomy and total vaginal hysterectomy in clinically similar groups of patients. METHODS From hospital-discharge data and...

Total laparoscopic hysterectomy (TLH) is the complete hysterectomy including transection of the uterine vessels and opening/closure of the vaginal vault performed laparoscopically. This procedure can be performed as an alternative to total abdominal hysterectomy in many cases. We previously found use of the harmonic scalpel to be extremely helpful in performing laparoscopically assisted vaginal...

BACKGROUND Despite the advantages of the vaginal and laparoscopic approaches, most hysterectomies carried out involve laparotomy. The objective of this prospective observational multicentre study was to examine the routes and complications of hysterectomy for benign disorders. METHODS Of the 15 university hospitals belonging to Collégiale de Gynécologie-Obstétrique de Paris-Ile de France, 12 ...

BACKGROUND Laparoscopically assisted vaginal hysterectomy has been promoted as a substitute for both abdominal and vaginal hysterectomy, with claimed benefits of lower costs, shorter hospital stays, and quicker postoperative recovery. METHODS Using computerized hospital-discharge data for 1988-1994 from 180 hospitals in Ohio, we analyzed rates of abdominal, vaginal, and laparoscopically assis...