Clinical Evaluation of Laparoscopically Assisted Radical Vaginal Hysterectomy with Bilateral Pelvic Lymphadenectomy

Lee, Y A; Kim, T J; Lim, K T; Lim, J E; Yang, K M; Chung, H W; Lee, K H; Shim, J U; Park, I S; Park, J T

Abstract

This paper reports our recent experiences in laparoscopically assisted radical vaginal hysterectomy with bilateral pelvic lymphadenectomy. The series consisted of 10 patients with gynecological malignancy operated upon between February, 1996 and June, 1996. Seven patients were invasive carcinoma of the cervix, less than 3 cm in tumor size, and three were carcinoma of the endometrium. The results, complication and feasibility of the procedure are as follows. The mean age of the patients was 47.9 years. Total length of the operation time ranged from 160 minutes to 420 minutes and the mean was 295.5 minutes. The mean hemoglobin decrement after the surgery was 1.7 gm/dl. The mean amount of the blood transfused during the procedure was 0.7 pints. The average number of lymph nodes removed was 20.7. After the surgery, the patients passed gas in average 2.5 days. The mean self voiding time was 9.2 days postoperatively. The only major surgical complication we encountered was a case of transsection of the right ureter which was repaired by laparotomy and end-to-end anastomosis. In conclusion, this technique is a feasible modality for the treatment of early uterine carcinoma and further development and improvement of laparoscopic instrument and adequate training will increase safety and reduce operation time. We believe it requires practice and interest.