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Surgical Endoscopy
Published in: Surgical Endoscopy 1/2015

01-01-2015

Hysterectomy via transvaginal natural orifice transluminal endoscopic surgery for nonprolapsed uteri

Authors: Chin-Jung Wang, Hui-Yu Huang, Chen-Ying Huang, Hsuan Su

Published in: Surgical Endoscopy | Issue 1/2015

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Abstract

Background

Natural orifice transluminal endoscopic surgery has shown its prospection as a minimally invasive endoscopic surgery. This study aimed to examine the safety and feasibility of transvaginal natural orifice transluminal endoscopic hysterectomy (tVNOTEH) for nonprolapsed uteri in the management of benign gynecological diseases.

Methods

Records were reviewed for the 147 consecutive tVNOTEH procedures between April 2011 and October 2013. Age, body mass index, number of vaginal delivery, and specimen weight were used to select comparable patient who had undergone laparoscopically assisted vaginal hysterectomy (LAVH).

Results

A total of 512 patients were recruited in this study (147 tVNOTEHs and 365 LAVHs, respectively). These patients were stratified into six subgroups according to the uterine weight and type of hysterectomy. There was no incidence of switching to abdominal laparatomy. Length of operation, estimated blood loss (EBL), requirement of blood transfusion, and length of postoperative stay were significantly greater in the LAVH group than in the tVNOTEH group but total hospital charges were higher in the tVNOTEH group (p < 0.001). There was no difference in overall incidence of operative complications between the two groups but more complications in LAVH for uterine weight more than 500 g (4.3 vs. 0 %, p < 0.001); this likely reflects higher hospital charges in this subgroup. Significant linear correlations of uterine weight with operating time and EBL existed in both groups.

Conclusion

tVNOTEH can be safely performed for large and nonprolapsed uterus. Besides, as uterine weight increased, the operative efficiency of tVNOTEH increases compared with LAVH.
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Metadata
Title
Hysterectomy via transvaginal natural orifice transluminal endoscopic surgery for nonprolapsed uteri
Authors
Chin-Jung Wang
Hui-Yu Huang
Chen-Ying Huang
Hsuan Su
Publication date
01-01-2015
Publisher
Springer US
Published in
Surgical Endoscopy / Issue 1/2015
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-014-3639-y

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