Laparoscopic Total and Supracervical Hysterectomy

Chapter

Abstract

Although described as a medical procedure since the second century, the concept of removing the uterus, or hysterectomy, for medical indications has undergone a profound journey from a shunned operation with almost 100 % mortality to one of the most common, nonobstetric operations performed today. Advances in instrumentation and minimally invasive techniques, described in this chapter, have made this a virtually outpatient procedure, with many indications and minimal complication rates. This chapter describes step-by-step techniques to achieve a minimally invasive approach to hysterectomy as well as indications and caveats to minimize medical mishaps. Mastery of the technique is transferable to other minimally invasive pelvic procedures.

Keywords

Harmonic Scalpel Total Laparoscopic Hysterectomy Lower Uterine Segment Uterine Manipulator Bipolar Cautery 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. 1.
    Wu JM, Wechter ME, Geller EJ, Nguyen TV, Visco AG. Hysterectomy rates in the United States, 2003. Obstet Gynecol. 2007;110:1091–5.PubMedCrossRefGoogle Scholar
  2. 2.
    Merrill RM. Hysterectomy surveillance in the United States, 1997 through 2005. Med Sci Monit. 2008;14:CR24–31.PubMedGoogle Scholar
  3. 3.
    US Department of Health and Human Services Centers for Disease Control and Prevention National Center for Health Statistics. Health, United States 2006 with chartbook on trends in the health of Americans. Table 99. Hyattsville; 2006.Google Scholar
  4. 4.
    Sutton C. Hysterectomy: a historical perspective. Baillieres Clin Obstet Gynaecol. 1997;11:1–22.PubMedCrossRefGoogle Scholar
  5. 5.
    Steptoe PC. Gynecological endoscopy-laparoscopy and culdoscopy. J Obstet Gynaecol Br Commonw. 1965;72:535–43.PubMedCrossRefGoogle Scholar
  6. 6.
    Reich H, de Cipro J, McGlynn F. Laparoscopic hysterectomy. J Gynecol Surg. 1989;5:213–5.CrossRefGoogle Scholar
  7. 7.
    Summitt Jr RL, Stovall TG, Lipscomb GH, Washburn SA, Ling FW. Outpatient hysterectomy: determinants of discharge and rehospitalization. Am J Obstet Gynecol. 1994;17:1480–4; discussion 1484–7.CrossRefGoogle Scholar
  8. 8.
    Semm K. Endoscopic subtotal hysterectomy without colpotomy; classic intrafascial Semm hysterectomy. A new method of hysterectomy by pelviscopy, laparotomy, per vaginam or functionally by total uterine mucosal ablation. Int Surg. 1996;81:362–414.PubMedGoogle Scholar
  9. 9.
    Sepillian V, Della Badia C. Iatrogenic endometriosis caused by uterine morcellation during a supracervical hysterectomy. Obstet Gynecol. 2003;102(5 pt 2):1125–7.CrossRefGoogle Scholar
  10. 10.
    Turner LC, Shepherd JP, Wang L, Bunker CH, Lowder JL. Hysterectomy surgical trends: a more accurate depiction of the last decade. Am J Obstet Gynecol. 2013;208:277.e1–e7.CrossRefGoogle Scholar
  11. 11.
    Klauschie J, Wechter ME, Jacob K, Zanagnolo V, Montero R, Magrina J, Kho R. Use of anti-skid material and patient-positioning to prevent patient shifting during robotic-assisted gynecologic procedures. J Minim Invasive Gynecol. 2010;17:504–7.PubMedCrossRefGoogle Scholar
  12. 12.
    Richardson EH. A simplified technique for abdominal panhysterectomy. Surg Gynaecol Obstet. 1929;48:248–51.Google Scholar
  13. 13.
    Anderson CK, Wallace S, Guiahi M, Sheeder J, Behbakht K, Spillman MA. Risk-reducing salpingectomy as preventative strategy for pelvic serous cancer. Int J Gynecol Cancer. 2013;23:417–21.PubMedCrossRefGoogle Scholar
  14. 14.
    Bojahr B, Raatz D, Schonleber G, Abri C, Ohlinger R. Perioperative complication rate in 1706 patients after a standardized laparoscopic supracervical hysterectomy technique. J Minim Invasive Gynecol. 2006;13:183–9.PubMedCrossRefGoogle Scholar
  15. 15.
    Kafy S, Huang JY, Al-Sunaidi M, Wiener D, Tulandi T. Audit of morbidity and mortality rates of 1792 hysterectomies. J Minim Invasive Gynecol. 2006;3:55–9.CrossRefGoogle Scholar
  16. 16.
    Alpern M, Kivnick S, Poon KY. Outpatient laparoscopic hysterectomy for large uteri. J Minim Invasive Gynecol. 2012;19:689–94.CrossRefGoogle Scholar
  17. 17.
    Uccella S, Ceccaroni M, Cromi A, Malzoni M, Berretta R, De Iaco P, et al. Vaginal cuff dehiscence in a series of 12,398 hysterectomies: effect of different types of colpotomy and vaginal closure. Obstet Gynecol. 2012;120:516–23.PubMedCrossRefGoogle Scholar
  18. 18.
    Blikkendaal MD, Twijnstra AR, Pacquee SC, Rhemrev JP, Smeets MJ, de Kroon CD, Jansen FW. Vaginal cuff dehiscence in laparoscopic hysterectomy: influence of various suturing methods of the vaginal vault. Gynecol Surg. 2012;9:393–400.PubMedCentralPubMedCrossRefGoogle Scholar
  19. 19.
    Ghomi A, Hantes J, Lotze EC. Incidence of cyclical bleeding after laparoscopic supracervical hysterectomy. J Minim Invasive Gynecol. 2005;12:201–5.PubMedCrossRefGoogle Scholar
  20. 20.
    Hilger WS, Magrina JF. Removal of pelvic leiomyomata and endometriosis 5 years after supracervical hysterectomy. Obstet Gynecol. 2006;108:772–4.PubMedCrossRefGoogle Scholar
  21. 21.
    Johns A. Supracervical hysterectomy vs total abdominal hysterectomy. Clin Obstet Gynecol. 1997;40:903–13.PubMedCrossRefGoogle Scholar
  22. 22.
    Parker WH, Fu YS, Berek JS. Uterine sarcoma in patients operated on for presumed leiomyoma and rapidly growing leiomyoma. Obstet Gynecol. 1994;83:414–8.PubMedGoogle Scholar
  23. 23.
    Theben JU, Schellong AR, Altgassen C, Kelling K, Schneider S, Große-Drieling D. Unexpected malignancies after laparoscopic-assisted supracervical hysterectomy (LASH): an analysis of 1584 LASH cases. Arch Gynecol Obstet. 2013;287:455–62.PubMedCrossRefGoogle Scholar
  24. 24.
    Einstein MH, Barakat RR, Chi DS, Sonoda Y, Alektiar KM, Hensley ML, Abu-Rustum NR. Management of uterine malignancy found incidentally after supracervical hysterectomy or uterine morcellation for presumed benign disease. Int J Gynecol Cancer. 2008;18:1065–70.PubMedCrossRefGoogle Scholar
  25. 25.
    Boosz A, Lermann J, Mehlhorn G, Loehberg C, Renner SP, Thiel FC, et al. Comparison of re-operation rates and complication rates after total laparoscopic hysterectomy (TLH) and laparoscopy-assisted supracervical hysterectomy (LASH). Eur J Obstet Gynecol Reprod Biol. 2011;158:269–73.PubMedCrossRefGoogle Scholar
  26. 26.
    Einarsson JI, Suzuki Y, Vellinga TT, Jonsdottir GM, Magnusson MK, Maurer R, et al. Prospective evaluation of quality of life in total versus supracervical laparoscopic hysterectomy. J Minim Invasive Gynecol. 2011;18:617–21.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  1. 1.Department of GynecologyWomen’s Health Institute, Cleveland Clinic FloridaFort LauderdaleUSA

Personalised recommendations