A Modified LAVH to Reduce Urinary Tract Injuries: 102 Consecutive Case-series at Srinagarind Hospital, Khon Kaen University
Kovit Khampitak MD*, Yuthapong Werawatakul MD*, Amornrat Supokhen MD*, Kanok Seejorn MD*
Affiliation : * Department of Obstetrics and Gynecology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
Objective : To describe the technique and results of modified laparoscopically assisted vaginal hysterectomy (LAVH), especially,
on the urinary tract injury.
Material and Method: One hundred two patients scheduled for modified LAVH between November 2007 and December 2010
were enrolled.
Results : The majority of patients were middle-aged. The median parity was two; 16 patients were nulliparous. Among the
39 patients who had undergone prior abdominal or pelvic surgeries, eight had a prior cesarean delivery. The majority of
LAVH indication was leiomyoma with complications. The median uterine weight was 300 g (range 120 to 1,450 g). The
median operating time was 105 min (range 50 to 365 min). One patient had repeated laparoscopic uterine artery
electrocoagulation 12 hours after surgery. Two patients were re-admitted with pelvic inflammatory disease (PID) two to
three weeks post-operatively. No bowel or urinary tract injuries were detected during intra- and post-operation.
Conclusion : The modified LAVH presented here was a technique that showed a low incidence of urinary tract injury.
Keywords : Hysterectomy, Laparoscopically assisted vaginal hysterectomy, Bladder injury, Ureteral injury, Laparoscopic hysterectomy
