Total Laparoscopic Hysterectomy – Retrospective Analysis of 1448 Cases for Bladder, Ureteric and Rectal Injuries and Post Operative Bleeding

Abstract

Study Objective: To assess the incidence of bladder, ureteric and rectal injuries and post operative bleeding in Total Laparoscopic Hysterectomy cases performed by a group of GYNs in Perth, Australia. Design: A retrospective study involving 1448 Total Laparoscopic Hysterectomy cases was conducted to document bladder, ureteric and rectal injuries and post operative bleeding. Setting: 4 Private GYNs using the Singh Uterine Cannula and Funnel to perform Total Laparoscopic Hysterectomy were interviewed. The operations were performed in 4 Perth Private Hospitals in Australia from 2002 to 2007. Patients: 1448 patients with Benign Uterine Disease. All patients underwent Total Laparoscopic Hysterectomy. Intervention: Total Laparoscopic Hysterectomy cases using the Singh Uterine Cannula and Funnel. Measurements and Main Results: 1448 patients underwent Total Laparoscopic Hysterectomy. There were 6 bladder incisions (0.41%), 1 ureteric injury (0.06%), and 5 vault bleeding (0.35%) requiring suturing in the OR. No rectal injuries were encountered. The bladder incisions were all in previous Caesarean cases. The ureteric injury followed the hysterectomy where severe pelvic sidewall endometriosis was being dissected. Conclusion: Total Laparoscopic Hysterectomy in Perth, Australia using the Singh Uterine Manipulator and Funnel was associated with a low incidence of Bladder and Ureteric injuries and Vault bleeding requiring suturing in the OR. No rectal injuries were encountered. The Technique and Equipment used will be described in another Abstract submitted to AAGL.