LAPAROSCOPIC HYSTERECTOMY FOR PERSISTENT GESTATIONAL TROPHOBLASTIC NEOPLASIA

We performed laparoscopic hysterectomy in a woman with persistent gest ational trophoblastic neoplasia. The procedure offered advantages over vaginal hysterectomy in that intraabdominal inspection was possible, morcellation was avoided, and the uterine arteries were transected bef ore uterine manipulation to avoid potential tumor embolization. In add ition, an abdominal incision was not required, and the patient had sho rter hospitalization and less pain than she would have had with the st andard abdominal procedure. Persistent, locally invasive gestational t rophoblastic neoplasia (GTN) develops in 15% of women after dilatation and evacuation for molar pregnancy.(1) Chemotherapy and hysterectomy are curative in virtually all patients. Numerous factors are considere d in deciding the primary mode of therapy. Women in whom fertility is not an issue may choose hysterectomy, which decreases the amount of ch emotherapy required to achieve cure. Traditionally, this has been perf ormed with an abdominal approach. We performed laparoscopic hysterecto my to manage GTN.