A TECHNIQUE OF MINILAPAROTOMY-ASSISTED VAGINAL HYSTERECTOMY

In minilaparotomy-assisted vaginal hysterectomy, the operation begins vaginally by opening the peritoneal folds and ligating the uterine ves sels and uterosacral ligaments. Minilaparotomy is then performed for m yomectomy, cutting the fallopian tubes and the utero-ovarian ligaments and detaching any adhesions on the anterior peritoneal angle. In 26 w omen who underwent this procedure, the feasibility rate was 100% and n o intraoperative complications or postoperative morbidity was observed (except in one case of ovarian bleeding), indicating that vaginal hys terectomy assisted by minilaparotomy is a feasible approach for hyster ectomy in the setting of large myomas, myomas with adhesions caused by endometriosis or previous pelvic surgery, and adenomyosis. Copyright (C) 1997 by The American College of Obstetricians and Gynecologists.