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Abdominale Hysterektomie

Obsoleter Dinosaurier oder forensische Renaissance?

Abdominal hysterectomy

Obsolete or experiencing a forensic renaissance?

  • Leitthema
  • Published:
Der Gynäkologe Aims and scope

Zusammenfassung

Um es gleich vorweg zu schreiben: Die Autoren dieses Artikels sind Gegner einer verbissenen Verfechtung von Operationstechniken. Es gibt mehrere Varianten einer Gebärmutterentfernung, von denen jede Vor- und Nachteile besitzt. Dieser Artikel betrachtet „engstirnig“ die abdominale Hysterektomie (AHE). Für den Benefit der Diskussion sei hier allerdings die in allen Leitlinien und in Metaanalysen klar favorisierte vaginale HE außen vor gelassen, die im Alltag zunehmend von der totalen laparoskopischen HE (TLH) ergänzt wird. Zudem soll hier keine Aufrechnung im Klein-Klein verschiedener Komplikationen (… bei der LAVH sind Harntraktverletzungen häufiger, bei der AHE Wundheilungsstörungen der Bauchdecke etc. pp.) erfolgen, sondern generelle Überlegungen hinsichtlich der Indikationsstellung getroffen werden. Aus Sicht der Autoren ist die „richtige“ HE-Technik, diejenige, mit der der Operateur sicher und die Patientin zufrieden ist.

Abstract

In the last decade a trend from abdominal access for hysterectomy to a laparoscopic approach could be observed. This article deals “close minded” with the abdominal (AHE) vs. laparoscopic hysterectomy in form of a classic pro-con discussion.

To get this straight: The authors dislike the grim discussion about surgical techniques. There are several hysterectomy variations of which each one has benefits and disadvantages. Also this article should not present a detailed list of complications (i. e. LAVH has more urogenital injuries, secondary wound healing is more common with AHE, …), but should provide a general reasoning for the surgical indication. The authors agree that the correct technique is the one the surgeon feels comfortable with and the patient is satisfied.

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Authors and Affiliations

  1. Universitätsfrauenklinik Ulm, Prittwitzstraße 43, 89075, Ulm, Deutschland

    N. de Gregorio &  F. Ebner

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  1. N. de Gregorio
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  2. F. Ebner
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Correspondence to N. de Gregorio.

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Interessenkonflikt

N. de Gregorio und F. Ebner geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

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W. Janni, Ulm

N. Maass, Kiel

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de Gregorio, N., Ebner, F. Abdominale Hysterektomie. Gynäkologe 49, 921–927 (2016). https://doi.org/10.1007/s00129-016-3965-3

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