EXPERIENCE WITH LAPAROSCOPIC HYSTERECTOMY

We conducted laparoscopic hysterectomy on 62 consecutive patients; 12 had laparoscopically assisted vaginal hysterectomy (LAVH), 16 had tota l laparoscopic hysterectomy (TLH), and 34 had supracervical laparoscop ic hysterectomy (SLH). The groups were comparable with regard to age, weight, history of abdominal surgery, number of additional procedures performed, and weight of specimens; 74% had previous abdominal surgery , and 69% had additonal procedures at hysterectomy. The mean estimated blood loss associated with LAVH was 2.5 times greater than that with TLH and 3 times greater than with SLH. The length of surgery was influ enced by patient selection, surgeon's experience, and equipment malfun ction, with a mean of 213 minutes for LAVH, 244 for TLH, and 212 for S LH. The mean hospital stay for LAVH was 1.9 days and less than 1 day f or TLH and SLH. There were nine total complications in the series (15% ). Twelve (19%) of the specimens showed no abnormalities on pathologic examination. Total and supracervical laparoscopic hysterectomy and LA VH are appropriate operations for selected patients and compare favora bly with standard abdominal or vaginal hysterectomy. The procedures de mand sophisticated instrumentation and a dedicated endoscopy team to e nsure safe and efficient performance.