Laparoscopic Management of Bladder Injury During Total Laparoscopic Hysterectomy

Objective: The rate of bladder injury during laparoscopic hysterectomy (LH) is three-fold higher than that of ureter injury and is an important problem for gynecologists. The aim of the present study was to present the results of laparoscopic repair of bladder injuries produced during LH procedure. Methods: Patients who underwent LH for benign indications between November 2018 and January 2020 were evaluated retrospectively. Medical records of all patients with bladder injury were reviewed and their causes of injury, incidence, treatment and follow-up were evaluated. Results: Eight patients were established to have bladder injury while undergoing LH. All bladder injuries were recognized during operation. Bladder injury occurred during laparoscopic sharp and blunt dissection of uterovesical area in seven patients and during suprapubic trochar insertion in one patient. All bladder injuries were repaired laparoscopically. No major complications were encountered during or after operation. Bladder catheters were removed 7–10 days after surgery. Conclusion: It was demonstrated that laparoscopic repair of bladder injury, which is a feared complication of LH, can be carried out successfully be gynecologists experienced in endoscopic surgery

Total Laparoscopic Hysterectomy Experience: Retrospective Results of a Tertiary Center

Objective: In the present study, it was aimed to retrospectively evaluate the intraoperative and postoperative outcomes of all laparoscopic hysterectomy procedures carried out at the obstetrics and gynecology department between January 2018 and September 2020. Methods: The files and operation case notes of 445 patients who underwent total laparoscopic hysterectomy for benign indications between January 2018 and September 2020 were retrieved from the hospital information management system and their intraoperative and postoperative outcomes were analysed. Results: The mean age of 445 patients included in the present study was 51.2±8.5 and parity 2.98±1.85, and the most common indication for hysterectomy was myoma uteri. The mean operation time was determined as 100.7±36.7 min. The overall major complication rate was 3.2% and the rate of conversion to laparotomy was found to be 1.5%. Conclusion: In patients who are not suitable for vaginal hysterectomy, total laparoscopic hysterectomy may be a reasonable option in terms of increasing the patient comfort, lower complication rates, and increasing the the experience of the surgical team