COMPLICATIONS OF 174 LAPAROSCOPIC HYSTERECTOMIES

The case records of 174 patients who underwent laparoscopic hysterecto my between September, 1992 and April, 1995 were retrospectively review ed. The mean age of the group was 45.4 (range 17.8-68.5) years, mean w eight 70.2 (50-121) kg and mean parity 2.3 (0-4). Laparoscopic hystere ctomy (i.e. uterine arteries secured laparoscopically) was performed i n 98 patients, laparoscopically assisted vaginal hysterectomy in 70, a nd laparoscopic subtotal hysterectomy in 6. Bilateral or unilateral oo phorectomy were performed in 40 cases. The mean operating time was 131 (45-285) minutes and mean hospitalization 2.6 (1-11) days. Endoscopic stapling devices were used in 135 cases, biopolar diathermy in 117, s utures and ties in 84, and the harmonic scalpel in 29. The overall com plication rate was 16%. Seven cases (4%) required conversion to laparo tomy. These included 2 inadvertent cystotomies (1 after 2 Caesarean se ctions), 3 cases of dense uterovesical adhesions following previous su rgery and 2 instances of excessive uterine size (>16 weeks). The mean follow-up period was 2.2 (1-18) months. One patient had a shortened va gina requiring dilatation and another had vault granulations requiring diathermy treatment. Overall 98.3% of patients were satisfied with th eir surgery.