Laparoscopic hysterectomy: General or gynecological surgery?

Background and aims. Laparoscopic hysterectomy, with or without associated exeresis of the adnexa, represents the most commonplace operation undergone by women in the United States. The laparoscopic technique used allows a minimum pelvic dissection to be made, with maximum saving in terms of the muscle and innervation of the pelvic floor, also permitting excellent control of the pelvic urether at the intersection with the uterine artery. Methods. A total of 8 hysterectomies and 3 hysteroadnexectomies were performed between January 1995 and June 1996 using a laparoscopic technique. Other gynecological operations carried out during the same period in this department included 9 myomectomies (of which 6 intramural myomas and 2 subserous myomas, with a diameter of between 2 and 4 centimetres), 18 monolateral adnexectomies and 1 bilateral adnexectomy for benign pathologies, 13 enucleated ovaric cysts and 1 salpingotomy. The mean duration of surgery in the authors' experience was 110 minutes (range 90-180). Results. No intra- or postoperative complications were reported. Conclusions. Patients were normally discharged on day II, with immediate return to normal daily activities and conservation of anatomic, functional and cosmetic integrity.