Laparoscopically Assisted Vaginal Hysterectomy for Women With Anterior Wall Adherence After Cesarean Section

Abstract

Objectives: To share and report experiences of using lateral approach technique to perform laparoscopically assisted vaginal hysterectomy (LAVH) for women with anterior wall adherence after cesarean section. Methods: We analyzed a retrospective chart review of 47 women with anterior wall adhesion after a cesarean section who underwent LAVH from March 1st 2003 to March 31st 2012, selected from a total of 1967 women who underwent LAVH during that period. Results: The median age of the patients was 42 years (range 34-56 years). The median operating time was 120 minutes (range 85-240 minutes), and the median weight of the removed uterus was 247 g (range 50-896 g). The median change in hemoglobin level was 2.0 g/dL (range 0-3.0 g/dL). The median hospital stay was 3.0 days (range 2-6 days). There were complications in 2 cases: bladder injury in one and postoperative ileus in the other. There were no conversions to laparotomy. Conclusions: Lateral approach technique to make a pneumoperitoneum and to perform adhesiolysis is effective in LAVH for women with anterior wall adherence after cesarean section.