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

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.