Laparoscopic subtotal hysterectomy using the plasma kinetic and lap loop systems: An alternative approach in the surgical management of women with uterine fibroids

• Published in: European journal of obstetrics & gynecology and reproductive biology 2008-03, Vol.137 (1), p.84-87
• Main Authors: Erian, John, El-Shawarby, Salem A, Hassan, Mohsen, Wissa, Ihab, Chandakas, Stefanos, Hill, Nicholas
• Format: Article
• Language: English
• Subjects: Adult; Biological and medical sciences; Digestive system. Abdomen; Endoscopy; Female; Female genital diseases; Follow-Up Studies; Gynecology. Andrology. Obstetrics; Humans; Hysterectomy - adverse effects; Hysterectomy - instrumentation; Hysterectomy - methods; Investigative techniques, diagnostic techniques (general aspects); Laparoscopic hysterectomy; Laparoscopy - adverse effects; Laparoscopy - methods; Leiomyoma - surgery; Medical sciences; Middle Aged; Minimally Invasive Surgical Procedures - adverse effects; Minimally Invasive Surgical Procedures - instrumentation; Minimally Invasive Surgical Procedures - methods; Obstetrics and Gynecology; Outcome Assessment (Health Care); Patient Satisfaction; Prospective Studies; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the genital tract and mammary gland; Surgical management; Tumors; Uterine fibroids; Uterine Neoplasms - surgery
• ISSN: 0301-2115; 1872-7654
• DOI: 10.1016/j.ejogrb.2007.01.004

Abstract Objective To evaluate the safety and applicability of laparoscopic subtotal hysterectomy (LSH) using the plasma kinetic (PK) and lap loop systems as an alternative surgical approach in the management of uterine fibroids in women who have completed their families. Study design Sixty-two consecutive LSH were performed during this prospective study from March 2003 to March 2005 at Princess Royal University Hospital, Kent, UK. Results All study patients had menorrhagia resistant to at least one form of therapy, with a mean duration of symptoms of 3.5 years. In addition, four patients had previous myomectomy. The mean number of fibroids removed was 2.7. The mean weight of the uterus was 141.9 g. The mean operative time was 46.8 min, and the mean blood loss was 126.6 mL. The overall perioperative complication rate was 4.8% with no visceral injury, or return to theatre. At follow-up, all patients were satisfied with surgery. Conclusion The study describes the first application of the PK and Lap Loop systems in LSH for the surgical management of uterine fibroids in women in whom fertility is not an issue, and its findings suggest that this minimally invasive technique is a safe, and valid alternative. Larger adequately-powered studies are however still required.